Table 1 Themes, subthemes and codes emerged from the data

Caregiver perceptions of children’s weight

Underestimation of children’s weight status

Thin, chubby, little fatties

Chubby children as a sign of good parental care

Normal for children to be chubby

OWO as sign of good parenting and feeding competence; chubby children a sign of good health

Chubby children are normal; will become thinner when growing up.

Caregiver beliefs about the health consequence of childhood OWO

Negative effect of OWO on short term health

Negative effects on long-term health

Bad for health; slower development, lacking confidence;

Diabetes, hypertension, metabolic diseases

Positive effects of childhood overweight

Less likely to get sick

Challenges related to dealing with childhood OWO

Difficulties controlling child’s dietary intake

Using food to stop children from crying; grandparents’ indulgent feeding practices; picky eaters; temptation of junk food.

Difficulties in increasing children’s physical activities

Lack of awareness among grandparents; lack of venues and facilities for physical activities

Inadequate guidance from health professionals

Inadequate communications and information from health providers

Information needs regarding childhood OWO prevention

Demand for more detailed advice on childhood feeding and physical activity

What foods to add at different month of age; what kind of and what level of exercise is suitable for children of different age

Access to reliable information

Public hospitals; information from professionals

Preference of online information

Not easy to get people together to attend lectures; Online information, e.g. via WeChat, is convenient.