Parental Feeding Practices Research Articles

Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases.

Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.

Influencias familiares en las prácticas de alimentación materna a niños preescolares de familias vulnerables de la Región Metropolitana de Chile

ObjectiveTo explore family members’ influences on mothers’ feeding practices of preschoolers in Chilean families residing in vulnerable neighborhoods from the Metropolitan Region of Santiago, Chile. DesignQualitative study. LocationNine child care centers in Región Metropolitana, Santiago, Chile. ParticipantsTwenty-four mothers and one father of preschool children. MethodPhoto-elicitation techniques were applied to 25 semi-structured interviews and their subsequent inductive thematic analysis of family influences. ResultsThe participants described that the family influences on their feeding practices depended on the family structure and the interpersonal closeness between relatives. Some influences directly affected child eating behavior, especially in relatives who live together, while others were mediated by the relationships generated between parents and other members of the family. Fathers, in two-parent families, and grandparents are the most influential relatives on the participants’ feeding practices. Generally, fathers participated and were in line with the mother's feeding practices of their children. Grandparents enriched their grandchildren's eating experiences by offering homemade preparations, expressing affection with food, including unhealthy options, and supporting parents to diversifying and structuring feeding practices. ConclusionsAccording to their interpersonal closeness or cohabitation, parental feeding practices and child eating behaviors were impacted by family members and their dynamics. The development of strategies to prevent and treat childhood obesity should consider a family approach in vulnerable families.

Moderating Effects of Parental Feeding Practices and Emotional Eating on Dietary Intake among Overweight African American Adolescents.

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child’s weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction (B = −0.331, SE = 0.162, p = 0.043), and concern (B = −0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents.

How Time in the US and Race/Ethnicity Shape Parents Feeding Practices and Child Diet Quality

ObjectivesChildhood obesity is a critical public health issue with short and long-term health and financial burdens. Studies show that childhood obesity is higher among children of immigrant/refugee households compared to children whose parents were born in the United States. Poor child dietary intake is a critical risk factor for elevated obesity prevalence. Nonetheless, parents feeding practices are known to be associated with child dietary intake. Thus, this study aimed to examine the associations between length of residence time in the US of migrants/refugees, parents feeding practices, and child diet quality while also taking into consideration race/ethnicity. MethodsData are from baseline measures of a longitudinal cohort study called Family Matters. The sample includes 1307 children ages 5–9 and their families from six racial/ethnic backgrounds. ResultsResults showed that feeding practices of immigrant/refugee parents changed in relation to their length of residency in the US, in particular, with regard to using directive (e.g., restriction), non-directive (e.g., modeling), and emotional feeding practices. Additionally, race/ethnicity was found to influence the relation between time length in the US and parents feeding practices. Moreover, the diet quality score changed in relation to parents’ length of time in the US. For example, Hmong children had the poorest diet quality compared to African American, Native American, Hispanic, Somali, and White children. ConclusionsFuture research should consider studying more in-depth why parent feeding practices may change when parents move to the US and explore whether there is a combination of parent feeding practices that are most useful in promoting healthful child diet quality. It is also important to further examine why child diet quality declines (e.g., Hmong children) with parents’ time living in the US as a migrant/refugee. Funding SourcesResearch is supported by grant number R01HL126171 from the National Heart, Lung, and Blood Institute (PI: Berge). Content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Describing Ecological Momentary Assessment Methods for Collecting Dietary Intake in a Racially/Ethnically Diverse Sample

ObjectivesEcological momentary assessment (EMA) is an innovative tool being used in the obesity field to capture real-time information about people’s health. A recent systematic review regarding the use of EMA to assess dietary intake and physical activity in youth found the need for standardized reporting of EMA measures and methods. This presentation will discuss EMA methods used in the NIH-funded Family Matters study, including survey design, registration/technology, EMA protocols, implementation, and lessons learned for future EMA studies. MethodsFamily Matters is an incremental, two-phased (Phase I = 150 participants; Phase II = 627 participants), mixed-methods study conducted with a racially/ethnically diverse and immigrant/refugee sample from largely low-income households. Across two phases, the Family Matters research team designed and administered EMA surveys to parents of 5–9 year olds to measure momentary factors of importance to child weight and weight-related behaviors including parent feeding practices, child eating behaviors, meal preparation, and foods served at family meals. ResultsEMA data allowed for many cutting-edge research questions to be addressed, innovative analyses to be run, and methodological approaches to be advanced. Many diet-related topics were investigated, including 1) the investigation of both within-and across-day relationships between transient and chronic stress and parent feeding practices; 2) parental stress and mood earlier in the day and its association with parent feeding practices later in the day; and 3) family meal characteristics by meal type and day of the week. Additionally, concordance between diet-related EMA measures and objectively collected 24-hour dietary recalls was examined. Family Matters EMA diet-related measures will be presented and related results discussed. ConclusionsThis presentation will be valuable for researchers interested in using EMA for collecting obesity-related measures, such as dietary intake, physical activity, parent feeding practices, and stress/mood. Funding SourcesResearch is supported by grant number R01HL126171 from the National Heart, Lung, and Blood Institute (PI: Berge).

Babybyte: Usability Testing of a mHealth App Prototype to Improve Responsive Feeding Practices in Parents of Infants and Toddlers

ObjectivesWith the recent addition of nutrition guidance for children under the age of 2 years to the 2020 Dietary Guidelines, new strategies are needed to communicate reputable feeding information to parents of infants and toddlers for optimal nutrition and prevention of early childhood obesity. The objective of this study was to determine usability of a mHealth app prototype (BabyByte) containing early childhood feeding guidance based on recommended responsive feeding practices for parents of children ages 0 to 2 years old. MethodsParents participated in one-on-one cognitive interviews about the basic use and navigation of BabyByte and were probed to locate specific sections within the app, read the information on each page, and complete interactive tasks. Interviews were conducted by a trained research assistant and recorded via Zoom software. Each participant also completed the mHealth App Usability Questionnaire (MAUQ) to rate overall usability, ease of use, interface satisfaction, and usefulness based on a 7-point Likert Scale. Mean MAUQ scores were calculated, with higher scores indicating higher usability of the app. Interview audio files were transcribed verbatim and response themes were aggregated using a content analysis approach. ResultsParents (n = 20) were, on average, 30.7 years old with the majority self-reporting as white (95%), Hispanic (55%), having a bachelor’s degree or higher (65%), working full-time (55%), and currently married (80%). On average, parents agreed or strongly agreed (6.5 ± 0.7 out of 7) that the app had high usability based on the MAUQ results. Ease of use (6.64 ± 0.6), interface and satisfaction (6.4 ± 0.9), and usefulness (6.3 ± 1.0) of the app received high ratings. Interview responses indicated that parents found the app prototype to be user-friendly and intuitive. Suggestions included minor changes in delivery, layout, and addition of supplemental and interactive content thus demonstrating the fit of the mHealth app with parent needs and preferences. ConclusionsParents of children ages 0 to 2 years old favorably rated the usability of BabyByte. With further revisions and expansion, BabyByte may be a feasible intervention tool to improve responsive practices by parents and prevent early childhood obesity. Funding SourcesUniversity of Florida CTSI

Influence of Parental Mindful Eating Practices on Child Emotional Eating: A Systematic Review of the Literature

Abstract Objectives Parents and caregivers shape the social and environmental factors that influence a child's intake and eating behaviors. Parental feeding practices may lead to recurring emotional eating in the child. Mindful eating practices may decrease emotional eating behaviors in adults and adolescents. The purpose of this systematic review was to investigate the influence of parental mindful eating on emotional eating behaviors of their children and adolescents. A second purpose of this systematic review was to determine whether parental or child participation in a mindful eating intervention improves emotional eating among children. Methods This review (PROSPERO 168,265) was conducted utilizing EBSCOhost to search five databases. The search was limited to full-text, peer-reviewed studies in the English language from 2014–2020. Studies included must have evaluated parental mindful eating and child emotion- or stress-related eating. Studies were excluded if parents were not involved and mindful eating/feeding/or parenting and child emotional eating were not measured. Authors used standard Cochrane methodological procedures. The process identified seven studies. Results Among the four cross-sectional studies, parental mindful eating/feeding/parenting skills were either directly or indirectly related to decreased emotional eating in the child or adolescent. However, the effect was unclear among the experimental studies. Most of these studies were pilot feasibility studies. Measures of mindful and emotional eating differed across studies. Conclusions Parental mindful eating may improve emotional eating behaviors among children and adolescents. Randomized controlled trials are needed to evaluate parent mindful eating interventions on child and adolescent eating behaviors. Future trials need to use similar validated measures to ensure consistent quality data collection and allow for comparison of findings across studies. Funding Sources N/A.

Infant Feeding Practices Among a U.S. Network of Milk-Sharing Parents

ObjectivesOver the past decade, peer-to-peer human milk sharing (PHMS) as an infant feeding strategy has been growing in popularity. Given the emergent nature of modern PHMS, little is known about the infant feeding practices (IFP) of parents who engage in PHMS. The objective of this study was to characterize the IFP among a network of PHMS families and identify differences in IFP by recipient/donor status. MethodsA cross-sectional survey was circulated among a network of PHMS families in the Washington, DC region. Eligible participants completed a detailed online survey about their milk sharing experiences and IFP. Bivariate analyses of IFP were conducted by PHMS status. To assess for differences in IFP by PHMS status, independent t and chi-square tests were used for continuous and categorical variables, respectively. ResultsAmong a sample of 168 PHMS parents, 58% were donors and 42% were recipients. Compared to recipients, donors had a longer mean duration of most recent lactation (17.4 vs. 12.3 months; p < 0.005). During the first 3 months of their children’s lives, recipients were more likely than donors to have fed them commercial infant formula (41.4% vs. 23.5%; p < 0.05) and banked donor milk (15.7% vs. 1%; p < 0.005). Donors were more likely than recipients to report ever having produced more milk than needed by their children (91.8% vs. 28.6%; p < 0.001), and less likely to report ever having difficulty producing enough milk for their children (20.4% vs. 77.1%; p < 0.001). Over a quarter of participants had ever exclusively pumped to feed their children, with no difference by PHMS status. While milk sharing, 86% of recipient infants were still consuming their mother’s own milk and 58% were still feeding at their mother’s breast. ConclusionsThis descriptive analysis demonstrates that PHMS participants are achieving a high duration of human-milk-feeding, far above the U.S. average. Lactation duration and breastfeeding experience between donors and recipients differed in predictable ways. Exclusive pumping was a common IFP among this sample of PHMS parents. Recipients in this sample were largely using PHMS as a strategy to supplement the mother’s own milk. Additional research is needed to understand how PHMS is being practiced and to identify infant health and growth outcomes associated with PHMS. Funding SourcesNIH Training Grant T32 HD087137.

Learned Experience and Resource Dilution: Conceptualizing Sibling Influences on Parents' Feeding Practices.

Studies from diverse cultures report mixed results in the relationship between birth order and risk for obesity. Explanations may thus lie in the postnatal period when growth is shaped by the family environment, including parental feeding practices, which may be affected by siblings. Consistent with a family systems perspective, we describe two processes that may explain birth order effects on parental feeding practices and child outcomes: learned experience and resource dilution. Parents learn from experience when earlier-born children influence their parents’ knowledge, expectations, and behavior toward later-born siblings through their behaviors and characteristics—which can have both positive and negative implications. Resource dilution is a process whereby the birth of each child limits the time, attention and other resources parents have to devote to any one of their children. The goal of this review is to provide a theoretical basis for examining potential sibling influences on parental responsive feeding toward developing recommendations for future research and practice aimed at preventing obesity throughout family systems.

The Moderating Effects of the Families Improving Together (FIT) for Weight Loss Intervention and Parenting Factors on Family Mealtime in Overweight and Obese African American Adolescents.

Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child’s weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent’s weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.

Feeding Problems in Typically Developing Young Children, a Population-Based Study.

Feeding problems have been estimated to occur in approximately 25–45% of normally developing children. The aim of this study was to investigate the prevalence of feeding problems in typically developing young children in Greece. Child feeding behavior, parents’ feelings about their child’s feeding patterns, and parental feeding practices were also explored. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Data on 742 healthy, typically developing children aged two to seven years are presented. Overall, the majority of children in the sample showed high frequency of desirable mealtime behaviors and low frequency of undesirable mealtime behaviors. However, a significant proportion of the cohort presented with food neophobia and low consumption of vegetables. When applying test cut-off scores, it was found that 8.2% of the sample had abnormal Total Frequency Score (TFS) and 26.6% had abnormal Total Problem Score (TPS). The study showed that parent-reported feeding problems are quite common in children of typical development in Greece. Moreover, while the majority of the sample displayed a high frequency of favorable behaviors, specific child feeding behaviors are amenable to improvement.

Head Start Parents With or Without Food Insecurity and With Lower Food Resource Management Skills Use Less Positive Feeding Practices in Preschool-Age Children

BackgroundFood resource management (FRM), strategies to stretch limited food resource dollars, may mitigate the impact of household food insecurity (HFI) on family members, including young children. However, little is known about how FRM and HFI are associated with child feeding practices. ObjectivesThe study aimed to explore relationships between HFI, FRM, and child feeding practices of low-income parents. MethodsIn a cross-sectional sample of 304 Head Start households, caregivers completed the USDA HFI module [classifying them as either food secure (FS) or food insecure (FI)], FRM behavior subscale (classifying them as being high or low in management skills based on a median score split), Comprehensive Feeding Practices Questionnaire, and Perceived Stress Scale. Households were categorized into 4 HFI-FRM subgroups: FS/high FRM (30.6%), FS/low FRM (31.3%), FI/high FRM (18.8%), and FI/low FRM (19.4%). Multivariable linear regression was used to examine whether feeding practices differed across HFI-FRM categories and whether the addition of parental perceived stress contributed to differences in feeding practices by HFI-FRM group. ResultsIn our study, 38% of households were FI. Compared to the FS/high FRM group in the adjusted models, the FS/low FRM group used less monitoring (−0.53; 95% CI: −0.78 to −0.28), modeling (−0.38; 95% CI: −0.64 to −0.13), and involvement (−0.57; 95% CI: −0.82 to −0.32) in feeding. A similar pattern emerged for the FI/low FRM group. The use of food as a reward was higher in the FI/high FRM (0.35; 95% CI: 0.02–0.67) and FI/low FRM groups (0.33; 95% CI: 0.01–0.66) compared to the FS/high FRM group. Perceived stress was positively associated with the use of negative, controlling feeding practices, and contributed to differences in using food as a reward within the HFI-FRM group. ConclusionsSuboptimal child feeding is evident in low-income caregivers with low FRM skills, with or without food insecurity. Promoting high FRM skills, in addition to addressing food insecurity, could potentially synergistically improve child feeding practices in low-income households.

Parental health literacy and nutrition literacy affect child feeding practices: A cross-sectional study

Health literacy (HL) and nutrition literacy (NL) are important issues to consider, in the provision of health care to children and the establishment of healthy eating behaviors. The study investigates the possible role of HL and NL levels of Greek parents, in parental Feeding Practices (PFP). This is a cross-sectional study which was conducted in the urban area of the Attica region, Greece. The sample consisted of 402 parents (68.4% mothers). Parents completed the Greek version of Comprehensive Parental Feeding Questionnaire, the European Health Literacy Questionnaire 47 and the Greek version of the Nutrition Literacy Scale. Sociodemographic and anthropometric characteristics were also assessed. The non-parametric tests Mann-Whitney and Kruskal Wallis, the chi-square test and linear regression models were applied. The median for HL and NL were 33.69 and 24.00, respectively. Mothers applied the "child control" practice more frequently than fathers (p = 0.015). Linear regression analysis revealed that HL was associated positively with "healthy eating guidance" and "monitoring" (p = 0.009 and p < 0.0001, respectively) and negatively with "emotion regulation/food as reward" and "child control" (p = 0.037 and p = 0.015, respectively). NL was associated positively only with "healthy eating guidance" (p = 0.009), positively but marginally with "monitoring" (p = 0.051) and negatively with "emotion regulation/food as reward" (p = 0.020). Higher parental levels of HL and NL are significantly positively associated with better parental feeding practices in Greece.

Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis.

Web-based parent interventions designed to promote children's healthy eating patterns can enhance parents' engagement and facilitate behavior change. However, it is still unclear how much the existing programs focus on changing parental feeding practices, and if so, which behavioral methodologies are used and how effective these interventions are in changing these parental behaviors. This systematic review and meta-analysis studied randomized controlled trials of web-based interventions targeting parents of 0-12-year-old children, aiming to promote children's healthy diet or prevent nutrition-related problems and reporting parental feeding behaviors as one of the outcomes. We conducted an electronic search in four databases from the earliest publication date until February 2020. Of the 1271 records found, we retained twelve studies about nine programs, comprising 1766 parents that completed the baseline evaluation. We found recent interventions, mainly directed to parents of young children, with small, non-clinical samples, and mostly theory-based. The programs were heterogeneous regarding the type of intervention delivered and its duration. The most assessed parental feeding practices were Restriction, Pressure to eat, and Food availability/accessibility. The behavior change techniques Instruction on how to perform the behavior, Demonstration of the behavior, and Identification of self as role model were frequently used. Meta-analytic results indicated that most programs' effects were small for the evaluated parental practices, except for Food availability/accessibility that benefited the intervention group only when all follow-up measurements were considered. The development of high-quality and controlled trials with larger samples is needed to determine with greater certainty the interventions' impact on parental feeding behaviors. The more frequent inclusion of measures to evaluate parental practices to support children's autonomy and of self-regulatory strategies as intervention components should be considered when designing programs.

Associations between Children's Genetic Susceptibility to Obesity, Infant's Appetite and Parental Feeding Practices in Toddlerhood.

Previous findings suggest that parental feeding practices may adapt to children’s eating behavior and sex, but few studies assessed these associations in toddlerhood. We aimed to study the associations between infant’s appetite or children’s genetic susceptibility to obesity and parental feeding practices. We assessed infant’s appetite (three-category indicator: low, normal or high appetite, labelled 4-to-24-month appetite) and calculated a combined obesity risk-allele score (genetic risk score of body mass index (BMI-GRS)) in a longitudinal study of respectively 1358 and 932 children from the EDEN cohort. Parental feeding practices were assessed at 2-year-follow-up by the CFPQ. Three of the five tested scores were used as continuous variables; others were considered as binary variables, according to the median. Associations between infant’s appetite or child’s BMI-GRS and parental feeding practices were assessed by linear and logistic regression models, stratified on child’s sex if interactions were significant. 4-to-24-month appetite was positively associated with restrictive feeding practices among boys and girls. Among boys, high compared to normal 4-to-24-month appetite was associated with higher use of food to regulate child’s emotions (OR [95% CI] = 2.24 [1.36; 3.68]). Child’s BMI-GRS was not related to parental feeding practices. Parental feeding practices may adapt to parental perception of infant’s appetite and child’s sex.

An Ecological Perspective of Food Choice and Eating Autonomy Among Adolescents

Adolescence is an important developmental period marked by a transition from primarily parental-controlled eating to self-directed and peer-influenced eating. During this period, adolescents gain autonomy over their individual food choices and eating behavior in general. While parent-feeding practices have been shown to influence eating behaviors in children, little is known about how these relationships track across adolescent development as autonomy expands. The purpose of this qualitative study was to identify factors that impact food decisions and eating autonomy among adolescents. Using the food choice process model as a guide, four focus groups were conducted with 34 adolescents. Focus group discussion was semi-structured, asking teens about influences on their food choices across different food environments, their involvement with food purchasing and preparation, and perceived control over food their choices. Focus group transcripts were analyzed using deductive and inductive code creation and thematic analysis. This study found six leading influences on adolescents' food choices and identified additional factors with prominence within specific environmental contexts. This study distinguished a broader spectrum of factors influencing adolescent food choice that extend beyond “convenience” and “taste” which have previously been identified as significant contributors. The degree of control that teens reported differed by eating location, occasion, and social context. Finally, adolescents demonstrated various levels of engagement in behaviors related to their eating autonomy. Identifying the emergent themes related to adolescent autonomy was the first step toward the goal of developing a scale to evaluate adolescent eating autonomy.

Parental phone use during mealtimes with toddlers and the associations with feeding practices and shared family meals: a cross-sectional study

BackgroundPositive parental feeding practices and a higher frequency of family meals are related to healthier child dietary habits. Parents play an essential role when it comes to the development of their child’s eating habits. However, parents are increasingly distracted by their mobile phone during mealtimes. The aim of this study was to describe the feeding practices and daily shared family meals among parents who use and do not use a mobile phone during mealtimes, and further to explore the associations between the use of a mobile phone during mealtimes and feeding practices and daily shared family meals, respectively.MethodsCross-sectional data from the Food4toddler study were used to explore the association between mobile use during meals and parental feeding practices including family meals. In 2017/2018 parents of toddlers were recruited through social media to participate in the study. In total 298 out of 404 who volunteered to participate, filled in a baseline questionnaire, including questions from the comprehensive feeding practices questionnaire (CFPQ), questions of frequency of family meals and use of mobile phone during meals.ResultsHerein, 4 out of 10 parents reported various levels of phone use (meal distraction) during mealtimes. Parental phone use was associated with lower use of positive parental feeding practices like modelling (B = − 1.05 (95% CI -1.69; − 0.41)) and family food environment (B = − 0.77 (95% CI -1.51; − 0.03)), and more use of negative parental feeding practices like emotional regulation (B = 0.73 (95% CI 0.32; 1.14)) and the use of pressure to eat (B = 1.22 (95% CI 0.41; 2.03)). Furthermore, parental phone use was associated with a lower frequency of daily family breakfast (OR = 0.50 (95% CI 0.31; 0.82)) and dinner (OR = 0.57 (95% CI 0.35; 0.93)).ConclusionsMobile phone use is common among parents during mealtimes, and findings indicate that parental phone use is associated with less healthy feeding practices and shared family meals. These findings highlight the importance of making parents aware of potential impacts of meal distractions.Trial registrationISRCTN92980420. Registered 13 September 2017. Retrospectively registered.

Parental considerations during complementary feeding in higher income countries: a systematic review of qualitative evidence.

Worldwide data suggest a clash between parental complementary feeding practices and recommendations. Understanding the circumstances under which parents form their feeding practices is a crucial step to improve such practices. This paper aimed to systematically review the existing qualitative literature and synthesise the factors that parents take into consideration in relation to complementary feeding. A systematic review was undertaken. Four electronic databases were searched for qualitative studies published after 2001 exploring parental experiences during complementary feeding. A framework that included authors' outcomes of interest was used to extract and synthesise study findings. The Standards for Reporting Qualitative Research were used to critically assess the included studies. Upper-middle- and high-income countries. Parents with a child below the age of 3 years. A total of forty-seven studies met the eligibility criteria and were included in this systematic review. The themes were organised into three main categories: (1) factors related to introduction of complementary foods; (2) factors related to the type of complementary foods and (3) factors related to both timing and type. The selected literature highlights: prevalent baby cues that prompt parents to introduce solid foods; parents' views on the recommended timing of complementary feeding; factors that drive the choice of complementary foods and perceived value in advice received from health professionals and grandmothers. This systematic review indicates factors that can be barriers to complying with the complementary feeding guidelines, and therefore, its findings are pertinent to improving parental feeding practices through intervention studies and through infant feeding education in a primary care setting.

Parental Perception of Weight and Feeding Practices in SchoolChildren: A Cross-Sectional Study

Childhood obesity has become a public health problem. Parents play an important role in the transmission of feeding habits and the detection of their child′s weight status. The aim was to analyse the prevalence of overweight/obesity and to determine the relationship between children′s weight status, different feeding practices and weight misperception. A cross-sectional study was conducted in randomly selected schools. The children’s weight status was measured, and a questionnaire was used to identify the feeding practices applied by parents and their perception of their children′s weight. The sample comprised 127 children aged 4 and 5 years and 189 aged 10 and 11. Differences were observed between parental feeding practices and weight status, monitoring being the most used practice. Parents use less pressure to eat and more restriction if their children have overweight or obesity. Misperception of weight was 39.6%, being higher in overweight children, who were perceived as normal weight in 53.19%. Children classified as obese were perceived as overweight in 88.23%. The use of inappropriate eating practices shows a need for health education in parents according to weight status. In addition, the parents’ perception should be improved to increase early detection of overweight and start actions or seek professional help.

Longitudinal patterns of food insecurity, the home food environment, and parent feeding practices during COVID-19.

BackgroundThe economic impacts of the coronavirus disease 2019 (COVID‐19) have drastically increased food insecurity in the United States. Initial data, collected a few months into the pandemic, showed that families, particularly those experiencing food insecurity, reported detrimental changes to their home food environment and parent feeding practices, compared to before COVID‐19.ObjectiveThis follow‐up study obtained longitudinal data from a sample of parents in the United States to quantify changes in food security status, the home food environment, and parent feeding practices, from before to across COVID‐19 as the pandemic continued to persist.MethodsParents (N = 433) completed online surveys May (T1) and September (T2) 2020 during COVID‐19. Food security, home food environment, and parent feeding practices were reported at each timepoint. At T1, parents also retrospectively reported on these factors pertaining to before COVID‐19. Chi square analyses and repeated measure mixed models examined associations among study variables.ResultsLow or very low food security increased from before COVID‐19 (37%) to T1 (54%) and decreased by T2 (45%). About 30% of families who became food insecure, and 44% who stayed food insecure from T1 to T2, reported a decrease in total food in their home; only 3%–6% who became/stayed food secure reported this decrease. Parents' concern for child overweight and use of monitoring increased from before COVID‐19 to T1, and decreased by T2, but remained elevated above pre–COVID‐19 values.ConclusionRates of food insecurity remain high as this pandemic persists. Continued assessment of nutrition‐related factors and increased economic supports are critical for families to endure COVID‐19 and prevent long‐term obesity and health risks.