Multi-site Trial Using SMS to Improve Infant Weight

The goals of this multi-site clinical trial are to pilot test weekly SMS sent to
parents/caregivers of infants to improve feeding practices and decrease excessive weight gain
in infants who are participants of the WIC program in two distinct locations, Puerto Rico and
Hawaii; to assess acceptability and practicality of the intervention; and to assess
acceptability of collecting blood spots in future studies. The investigators will recruit a
convenience sample of parent/caregivers of infants 0-2 months participating in the WIC
program in Puerto Rico and Hawaii to send weekly SMS for 4 months. The weekly messages will
focus on reinforcing the breastfeeding messages provided by WIC, preventing overfeeding,
delaying introduction of solid foods, and delaying and reducing baby juice consumption, which
are key issues in low-income populations. Participants will complete validated questionnaires
and anthropometry before and after the trial and results will be compared to the control
group (no messages). Participants will also answer short questions by SMS at different points
and an interview at the end of the trial to assess the SMS. The investigators will assess how
many participants agree to collect blood spots in their infants in future studies.

Inclusion Criteria:

- Caregiver age 18 years and older

- owner of a mobile phone with unrestricted SMS capability

- responsible for the care of the infant and willing to actively participate for the
full duration of the study.

Exclusion Criteria:

- infants with special diets

- infants with limited mobility

- pre-term birth (<37 weeks)

- small or large for gestational age (birthweight <10th or >90th p)

- inability to consent to participate in the study

- unwillingness to be randomized and not being able to read