Parent feeding practices in infants and toddlers referred to a hospital-based feeding program in the United States

Abstract

While considerable research exists on parent feeding practices for infants and toddlers, past research has not focused on children with feeding problems. The goal of this study was to identify parent feeding practices in a sample of infants (n = 178) and toddlers (n = 221) referred to a hospital-based feeding clinic and then examine how these parent feeding practices were correlated with specific feeding problems. Parents completed surveys to report child demographics, feeding problems, and use of 54 feeding practices. Forty-eight (88.8%) of 54 practices were utilized more often for toddlers than for infants. Exploratory factor analysis with the 54 practices and the full sample (n = 399) produced the 16-item Baby Parent Mealtime Action Scale (BPMAS) with three dimensions: Multiple Food Offers, Use of Cereal/Pureed Foods, Use of Toys/TV. Controlling for demographics, hierarchical regression examined how each BPMAS dimension was associated with five feeding problems (underweight, tube feeding, texture problems, limited diet, mealtime disruption). Multiple Food Offers (e.g., daily offering of vegetables, offering foods from the family meal) was the dimension most correlated with fewer feeding problems such as tube feeding (β = −0.220, p < 0.001), texture rejection (β = −0.361, p < 0.001), and limited diet variety (β = −0.175, p < 0.001), but also with more mealtime disruption (β = 0.231, p < 0.001). Use of Toys/TV was correlated with more mealtime disruption (β = 0.260, p < 0.001). In addition to demonstrating a correlation between parent feeding practices and feeding problems, this study also found adding cereal/pureed foods to be common and while the dimension, Use of Cereal/Pureed Foods, was not significantly correlated with any specific feeding problem, this dimension provides an expanded understanding of cereal usage.