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Objectives: To determine the frequency of 14 discipline strategies used by mothers (n = 564) and fathers (n = 335) in caring for their six-month old infant. Methods: Data on discipline practices were obtained from families participating in an obesity prevention trial (Prevention of Overweight in Infancy). Each parent was asked to indicate the frequency of using 14 different discipline strategies during the previous week with their infant. Associations between the use of these strategies and parity, deprivation, parental ethnicity, depression symptoms and infant sex were investigated. Results: Parents reported using both positive (mean: 8.8 for mothers and 7.9 for partners) and negative (0.7 for mothers and 0.7 for partners) strategies over the past week. At six months, positive strategies such as smiling, praising and distraction were most commonly reported (=87% for both mothers and partners), negative strategies such as smacking, time out and shouting being reported infrequently (=8% for all). Discipline requiring a level of cognitive understanding not developed at six months was reasonably common, including reasoning (17.7% for mothers, 23.4% for partners), negotiation (6.2%, 11.7%) and ignoring (26%, 19%). Multivariate analysis demonstrated that mothers with more than one child had a lower positive discipline index than those with only one child (difference, 95% C.I.: 1.05 (0.57, 1.54). An increase of one point on the 10-point hostile parenting scale was associated with an increase of 0.18 (0.04, 0.31) for the mothers and 0.47 (0.23, 0.70) for partners on the negative strategy index. Conclusions: Discipline strategies emerge early in infancy and are associated with family size and parental hostility.

Abstract Background Rapid weight gain during the first three years of life predicts child and adult obesity, and also later cardiovascular and other morbidities. Cross-sectional studies suggest that infant diet, activity and sleep are linked to excessive weight gain. As intervention for overweight children is difficult, the aim of the Prevention of Overweight in Infancy (POI.nz) study is to evaluate two primary prevention strategies during late pregnancy and early childhood that could be delivered separately or together as part of normal health care. Methods/Design This four-arm randomised controlled trial is being conducted with 800 families recruited at booking in the only maternity unit in the city of Dunedin, New Zealand. Mothers are randomised during pregnancy to either a usual care group (7 core contacts with a provider of government funded "Well Child" care over 2 years) or to one of three intervention groups given education and support in addition to "Well Child" care: the Food, Activity and Breastfeeding group which receives 8 extra parent contacts over the first 2 years of life; the Sleep group which receives at least 3 extra parent contacts over the first 6 months of life with a focus on prevention of sleep problems and then active intervention if there is a sleep problem from 6 months to 2 years; or the Combination group which receives all extra contacts. The main outcome measures are conditional weight velocity (0-6, 6-12, 12-24 months) and body mass index z-score at 24 months, with secondary outcomes including sleep and physical activity (parent report, accelerometry), duration of breastfeeding, timing of introduction of solids, diet quality, and measures of family function and wellbeing (parental depression, child mindedness, discipline practices, family quality of life and health care use). This study will contribute to a prospective meta-analysis of early life obesity prevention studies in Australasia. Discussion Infancy is likely to be the most effective time to establish patterns of behaviour around food, activity and sleep that promote healthy child and adult weight. The POI.nz study will determine the extent to which sleep, food and activity interventions in infancy prevent the development of overweight. Trial Registration Clinical Trials NCT00892983 Prospective meta-analysis registered on PROSPERO CRD420111188. Available from http://www.crd.york.ac.uk/PROSPERO