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Background Novel approaches to reduce sugar-sweetened beverage (SSB) consumption during the first 1000 days—pregnancy through age 2 years—are urgently needed. Objective To examine perceptions of SSB consumption and acceptability of potential intervention strategies to promote SSB avoidance in low-income families in the first 1000 days. Methods In this qualitative research, we performed semistructured, in-depth interviews of 25 women and 7 nutrition/health care providers. Eligible women were Women, Infants, and Children program-enrolled and pregnant or had an infant younger than age 2 years. Eligible providers cared for families during the first 1000 days. Using immersion-crystallization techniques, we examined perceptions, barriers, and facilitators related to avoidance of SSB consumption; acceptability of messages framed as positive gains or negative losses; and perceived influence on SSB consumption of various intervention modalities. Results Themes related to SSB consumption included parental confusion about healthy beverage recommendations and maternal feelings of lack of control over beverage choices due to pregnancy cravings and infant tastes. Themes surrounding message frames included negative health consequences of sugary drink consumption are strong motivators for behavior change; and savings and cost count, but are not top priority. Highly acceptable intervention strategies included use of images showing health consequences of SSB consumption, illustrations of sugar content at the point of purchase, and multimodal delivery of messages. Conclusions Messages focused on infant health consequences and parental empowerment to evaluate and select healthier beverages based on sugar content should be tested in interventions to reduce SSB consumption in the first 1000 days.

Objectives. To examine the relationship of parental sugar-sweetened beverage (SSB) attitudes with SSB consumption during the first 1000 days of life—gestation to age 2 years. Methods. We studied 394 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)–enrolled families during the first 1000 days of life in northern Manhattan, New York, in 2017. In regression models, we assessed cross-sectional relationships of parental SSB attitude scores with habitual daily parent SSB calories and infant SSB consumption, adjusting for demographic and socioeconomic characteristics. Results. Each point higher parental SSB attitude score was associated with lower parental SSB consumption (–14.5 median kcals; 95% confidence interval [CI] = −22.6, −6.4). For infants, higher parental SSB attitude score was linked with lower odds of infant SSB consumption (adjusted odds ratio [AOR] = 0.84; 95% CI = 0.71, 0.99), and adjustment for socioeconomic factors slightly attenuated results (AOR = 0.85; 95% CI = 0.71, 1.02). Conclusions. During the first 1000 days of life, greater negativity in parental attitudes toward SSB consumption was associated with fewer parental calories consumed from SSBs and lower likelihood of infant SSB consumption. Public Health Implications. Parental attitudes toward SSBs should be targeted in future childhood obesity interventions during pregnancy and infancy.