BMC Public Health 2008, 8:103 http://www.biomedcentral.com/1471-2458/8/103 time, and frequency of parent's watching television with their child has been found to be positively associated with children's television viewing [33]. Despite these trends, first-time parents may be particularly receptive to knowledge and skill development around parenting and the promotion of healthy family eating and physical activity behaviours. First-time parents regularly seek advice during their child's first year of life. In Victoria Australia, families make approximately 35 visits to health care providers for their infants during this first year [34]. Importantly, most visits to health service providers are not related to child illness, but rather reflect parental need for support and information during this period of rapid tran- sition. In addition, parents indicate high levels of concern regarding children's appetite, eating patterns and growth, and regularly express the need for more comprehensive guidance in these areas [35]. It is likely that messages delivered to first-time parents may be preferentially received if delivered at times in their child's development when they are actively seeking strategies to manage emerg- ing behaviours, an approach known as anticipatory guid- ance. Utilisation of anticipatory guidance Anticipatory guidance is heralded as a promising approach by which health practitioners might support parents to promote healthy weight in their children by being proactive, informing parents about what to expect and how to manage behaviour, as opposed to supporting parents to manage events after they occur [36-38]. Antici- patory guidance has been shown to be effective across a range of domains, including parent-infant interactions, sleep patterns, injury prevention and reading at home [39]. Despite the promise of anticipatory guidance as an educa- tive approach, just one study utilising this approach in the area of childhood eating has been published [40]. That study involved guidance of parents of new-borns regard- ing delaying introduction of solids. Compared to con- trols, the intervention resulted in positive differences in the types of foods introduced and increased confidence in health professionals as primary providers of information. A randomised-controlled trial targeting overweight indig- enous mothers of 1–3 year olds focused on parenting skills to promote improved child eating and physical activity patterns [41]. That study found intervention group infants had decreased relative weight, total energy intake, and improved parent-child interactions around food over 16 weeks. This high quality US study highlights that parents are willing and capable of making positive changes to improve their child's health and body weight. INFANT: preventing childhood obesity and promoting healthy life-style choices The INFANT project will employ an anticipatory guidance approach to support first-time parents attending a new parents' group to be skilled in their approaches to their infant's emerging dietary, physical activity and sedentary behaviours. The intervention will be delivered by an expe- rienced dietitian during infants' first 18 months of life at first-time parents groups held within Maternal and Child Health (MCH) centers. Evidence supports the proposition that education regarding lifestyle behaviours is feasible within existing MCH infrastructures and that it is likely to be effective [42,43]. Victoria's 80 MCH Centres (across 39 regions) are a cornerstone of service provision with 96% of all first-time parents attending [34]. MCH nurses rou- tinely establish first-time parents' groups through which education sessions are delivered. A recent prospective study [43] reported that 2/3rds of eligible first-time moth- ers joined these groups and that of these groups, 2/3rds were still meeting 18 months after the formal sessions had concluded. Drop out from such groups was estimated to be between 10 and 15%. That study also documents the important social environment that first-time mothers' groups provide throughout this early period of parenting. Given the stability of these pre-existing groups and the well-documented capacity of groups to support and rein- force the uptake of knowledge and skills we propose that these groups will provide an important vehicle by which we may deliver an intervention. In addition, our pilot work and engagement with local government areas has demonstrated that access to these groups via MCH nurses is feasible and that willingness of mothers within these groups to participate in research is high. While this intervention utilises professional support beyond that currently existing in MCH Centres, it remains modest in terms of total cost of implementation and is designed for long-term sustainability, with skills required easily transferable to MCH nurses and other comparable health professionals. The intervention draws on parenting support theory [44], which emphasizes children's psychological and behav- ioural goals, logical and natural consequences, mutual respect and encouragement techniques. Emphasis will be placed on parents' understanding of how improved parenting skills can facilitate the development of appro- priate eating and activity behaviours in children. In the feeding domain, these approaches have been operational- ised by Satter who promotes the 'Division of Responsibil- ity in Feeding' [45] This approach has also been adopted in the US Start Health Feeding Guidelines for Infants and Toddlers [46]. Havery-Berino et al [47] report, in one of the only relevant studies in this age group (age 9 to 36 Page 3 of 9 (page number not for citation purposes)