Child Mealtime Behavior Research Articles

Caregiver Role: Ideas about Feeding Infants and Toddlers

This work represents an initial effort to describe expectations and attitudes that might contribute to variation in the caregiving role as it relates to feeding young children. The study also investigates the impact of performance contexts on attitudes about one aspect of caregiving—feeding. One hundred twenty-four primary caregivers of typically developing infants from 4 to 28 months were interviewed about their expectations for developmental milestones related to feeding and their attitudes about how a parent should respond to different meal-time behaviors of children. Reliability of the instruments was explored. Test-retest reliability of caregiver expectations for when milestones were expected, as captured on Feeding Skills Development, ranged from good (.87) to poor (not significant). Reliability of attitudes captured by the second instrument, Feeding Stories, ranged from moderate to poor. The multidimensional contributions of temporal and social contexts on the attitudes of caregivers about feeding practices were examined. The older the participant the more relaxed approach to what and when a baby ate. The pattern of association of social context and parental value was different for participants who were African American and those who were white. Results are discussed in the light of possible factors that contribute to caregivers' ideas about their young child with special needs and feeding issues. It is suggested that these thoughts might frame how the caregiver responds to feeding intervention suggestions.

Relationship between observations of mother-infant interactions and maternal ratings of infant temperament and parenting stress

To examine the relationships among grandmother co-residence, parenting, and early child development among low income, urban families with teen mothers whose children vary in growth (adequate versus failure to thrive [FTT]).Seventy-nine adolescent mothers of infants and toddlers (42 with adequate growth and 37 with FTT) recruited from a primary care clinic. Data collected during a laboratory evaluation included a videotaped session of mother and child during feeding, developmental assessment (Bayley Scales), and questionnaires on family support, perceived parenting stress, and maternal perception of child's temperament.Multivariate analyses of covariance. Independent variables were growth (adequate/FTT) and grandmother co-residence (present/absent). Dependent variables were maternal warmth during feeding, maternal perception of child's temperament, child's mealtime behavior, and child's cognitive and motor development. Covariates were child's age, maternal age, maternal education, parity, family support, and perceived stress.Teen mothers living with grandmothers were younger (mean age = 17.4 versus 18.6, p = .03) and had fewer children (mean parity = 1.2 versus 1.7, p = .001). Mothers displayed more warmth when not living with grandmothers (p = .01). Among adequately growing children, grandmother co-residence was associated with better motor skills (106 versus 98, p = .039). In contrast, among children with FTT, grandmother co-residence was associated with lower motor skills (90 versus 100, p = .017).Although multigenerational families may be protective for some teen parents and their young children, grandmother co-residence was not associated with maternal warmth. With the added stress of a poorly growing child, grandmother co-residence was associated with less optimal motor development.

Grandmother co-residence, parenting, and child development among low income, urban teen mothers

To examine the relationships among grandmother co-residence, parenting, and early child development among low income, urban families with teen mothers whose children vary in growth (adequate versus failure to thrive [FTT]). Seventy-nine adolescent mothers of infants and toddlers (42 with adequate growth and 37 with FTT) recruited from a primary care clinic. Data collected during a laboratory evaluation included a videotaped session of mother and child during feeding, developmental assessment (Bayley Scales), and questionnaires on family support, perceived parenting stress, and maternal perception of child's temperament. Multivariate analyses of covariance. Independent variables were growth (adequate/FTT) and grandmother co-residence (present/absent). Dependent variables were maternal warmth during feeding, maternal perception of child's temperament, child's mealtime behavior, and child's cognitive and motor development. Covariates were child's age, maternal age, maternal education, parity, family support, and perceived stress. Teen mothers living with grandmothers were younger (mean age = 17.4 versus 18.6, p = .03) and had fewer children (mean parity = 1.2 versus 1.7, p = .001). Mothers displayed more warmth when not living with grandmothers (p = .01). Among adequately growing children, grandmother co-residence was associated with better motor skills (106 versus 98, p = .039). In contrast, among children with FTT, grandmother co-residence was associated with lower motor skills (90 versus 100, p = .017). Although multigenerational families may be protective for some teen parents and their young children, grandmother co-residence was not associated with maternal warmth. With the added stress of a poorly growing child, grandmother co-residence was associated with less optimal motor development.

Children with persistent feeding difficulties: An observational analysis of the feeding interactions of problem and non-problem eaters.

This study examined the relationship between parent's feeding practices and the feeding behavior of toddlers and preschool-age children with (n = 19) or without (n = 29) persistent feeding difficulties. Specifically, patterns of parent-child interaction were assessed during standardized family mealtime observations in the clinic. Parents also kept observational records of their children's mealtime behavior at home and rated the degree of difficulty they experienced in feeding their child during each meal on a daily basis. Observational results showed that feeding-disordered children engaged in higher levels of disruptive mealtime behavior (food refusal, noncompliance, complaining, oppositional behavior, and playing with food) and lower levels of chewing during mealtime. There were several significant age effects, with younger children (under age 3) engaging in more vomiting and less aversive demanding and verbalizations. Parents of feeding-disordered children were more negative and coercive in their feeding practices and engaged in higher levels of aversive instruction giving, aversive prompting, and negative eating-related comments. There were several significant associations between coercive parental behaviors and children's food refusal and noncompliance in the sample as a whole. Measures of children's disruptiveness at mealtimes in the clinic were significantly correlated with measures of mealtime behavior in the home.

Children with persistent feeding difficulties: an observational analysis of the feeding interactions of problem and non-problem eaters.

This study examined the relationship between parent's feeding practices and the feeding behavior of toddlers and preschool-age children with (n = 19) or without (n = 29) persistent feeding difficulties. Specifically, patterns of parent-child interaction were assessed during standardized family mealtime observations in the clinic. Parents also kept observational records of their children's mealtime behavior at home and rated the degree of difficulty they experienced in feeding their child during each meal on a daily basis. Observational results showed that feeding-disordered children engaged in higher levels of disruptive mealtime behavior (food refusal, noncompliance, complaining, oppositional behavior, and playing with food) and lower levels of chewing during mealtime. There were several significant age effects, with younger children (under age 3) engaging in more vomiting and less aversive demanding and verbalizations. Parents of feeding-disordered children were more negative and coercive in their feeding practices and engaged in higher levels of aversive instruction giving, aversive prompting, and negative eating-related comments. There were several significant associations between coercive parental behaviors and children's food refusal and noncompliance in the sample as a whole. Measures of children's disruptiveness at mealtimes in the clinic were significantly correlated with measures of mealtime behavior in the home.

Moulding

Excessive and impairing picky eating is a common problem among children for which there is little published research on efficacious psychosocial treatment. Extant research largely concerns single-case studies, or small samples of very young children, who are typically treated in hospital settings. This paper reports on outcomes of 21 children (ages 4–11) described by their parents as extremely picky eaters who met criteria for avoidant/restrictive food intake disorder not associated with a developmental disorder, other eating disorder, or other eating-related anxiety disorder (e.g., specific phobia of vomiting or choking). Seven cohorts of two to four families each took part in a seven-session manualized parent-only group treatment in an outpatient setting. This group treatment focused on training parents to serve as effective coaches for daily in-home exposures to nonpreferred foods, as well as in components of parent management training to reduce problematic mealtime behaviors. Parents completed standardized feeding measures to assess picky eating and associated problem mealtime behaviors at pretreatment, posttreatment, and at 3-month follow-up, as well as a satisfaction measure at posttreatment. Results showed excellent feasibility and adherence by parents and high parent satisfaction with treatment. Paired t tests to measure within-group change showed significant pre–post treatment reductions in picky eating scales with moderate to large effect sizes. Gains were maintained at 3-month follow-up. Findings indicate that a relatively brief group treatment that focuses specifically on training parents to facilitate and carry out food exposures and contingency management procedures in their homes is associated with reductions in functionally impairing picky eating and related negative mealtime behaviors in elementary school-age children.

Preventing Common Feeding Problems in Infants and Young Children

Feeding is one of many important ways that parents nurture their infants and children. When parents are overly concerned about feeding, they can exacerbate temporary feeding difficulties and misbehaviors by their inappropriate responses to the child's behavior. Child health supervision visits provide opportunities for the early detection of feeding problems, for education about early feeding experiences and typical child behavior at mealtimes, and for suggestions about the prevention of feeding problems. Handouts and printed materials can provide useful guidelines for introducing solid foods and for managing children's mealtime behavior. Early detection might reduce the likelihood that minor feeding disturbances will develop into severe feeding problems. Behavior management strategies and a pleasant social context for mealtimes can improve children's eating and mealtime behavior. Impairments in the parent-infant relationship may lead to serious feeding problems and referrals to appropriate support services are necessary. Prevention and early treatment of feeding problems can be facilitated by health education about early food experiences and the common developmental behaviors that occur as children grow and develop.

The effects of parental influences on children's food intake, physical activity, and relative weight

The current investigation assessed the relationship between observed child mealtime behavior, physical activity, selected parent behaviors, and child relative weight. Subjects were 30 (15 male, 15 female) preschool children varying in age from 22 to 46 months (mean = 30.5 months). Each subject and parents were observed during the dinnertime meal with an observational instrument designed to measure children's mealtime behaviors and parental influences on child eating. Further, children's activity levels were assessed for one hour and parental influences on child activity were observed. Results indicated that parental encouragements to eat correlated both with the percent of time the child ate and with child relative weight. Similarly, parental encouragements to be active correlated to extreme levels of child motor activity and negatively to relative weight. Implications of the current study are discussed and the present findings are compared and contrasted with previous research.

Parental influences on children's eating behavior and relative weight.

We investigated the relationship between selected parent behaviors, child mealtime behavior, and infant relative weight. Subjects were 7 male and 7 female children varying in age from 12 to 30 months (mean = 23.9 months). Each subject and parents were observed during the dinnertime meal on two occasions using the BATMAN (Bob and Tom's Method of Assessing Nutrition). The children spent 58% of the mealtime eating. They spent very little time making active decisions about what and how much they ate (food requests = 2% of the time; food refusals = 1% of the time). We found significant correlations between child relative weight and (a) parental prompts to eat (r = .81, p less than .001), (b) parental food offers (r = .51, p less than .05), and (c) parental encouragement to eat (r = .82, p less than .001). Thus, the present study suggests a relationship between certain parental variables and the relative weight of their children.