Maternal Feeding Styles Research Articles

Associations Between Maternal Depressive Symptoms and Nonresponsive Feeding Styles and Practices in Mothers of Young Children: A Systematic Review.

BackgroundChildhood obesity is a significant global public health problem due to increasing rates worldwide. Growing evidence suggests that nonresponsive parental feeding styles and practices are important influences on children’s eating behaviors and weight status, especially during early childhood. Therefore, understanding parental factors that may influence nonresponsive parental feeding styles and practices is significant for the development of interventions to prevent childhood obesity.ObjectiveThe objectives of this systematic review were to (1) identify and review existing research examining the associations between maternal depressive symptoms and use of nonresponsive feeding styles and practices among mothers of young children (2-8 years of age), (2) highlight the limitations of reviewed studies, and (3) generate suggestions for future research.MethodsUsing the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) guidelines, six electronic academic databases were searched for peer-reviewed, full-text papers published in English between January 2000 and June 2016. Only studies with mothers 18+ years old of normally developing children between 2 and 8 years of age were included. Of the 297 citations identified, 35 full-text papers were retrieved and 8 were reviewed.ResultsThe reviewed studies provided mixed evidence for associations between maternal depressive symptoms and nonresponsive feeding styles and practices. Two out of three studies reported positive associations with nonresponsive feeding styles, in that mothers with elevated depressive symptoms were more likely than mothers without those symptoms to exhibit uninvolved and permissive or indulgent feeding styles. Furthermore, results of reviewed studies provide good evidence for association between maternal depressive symptoms and instrumental feeding (3 of 3 reviewed studies) and nonresponsive family mealtime practices (3/3), but mixed evidence for pressuring children to eat (3/6) and emotional feeding (1/3). In addition, evidence for the association between maternal depressive symptoms and restricting child food intake was mixed: one study (1/6) found a positive association; two studies (2/6) found a negative association; whereas one study (1/6) found no association.ConclusionsThis review indicates that the results of studies examining the associations between maternal depressive symptoms and parental feeding styles and practices are mixed. Limitations of studies included in this review should be noted: (1) the use of a diverse set of self-report questionnaires to assess parental feeding practices is problematic due to potential misclassification and makes it difficult to compare these outcomes across studies, thus caution must be taken in drawing conclusions; and (2) the majority of included studies (6/8) were cross-sectional. There is a need for additional longitudinal studies to disentangle the influence of depression on parental feeding styles and practices. Nevertheless, given that depressive symptoms and feeding styles and practices are potentially modifiable, it is important to understand their relationship to inform obesity prevention interventions and programs.

The association between maternal perception of her child weight and maternal feeding styles

Introduction: Mothers do not recognize when their child is overweight or obese (OW-OB), and the evidence suggests a relationship between inadequate maternal perception of her child weight (MPCW), and maternal feeding style (MFS). Objectives: a) To assess the reliability of the Caregiver Feeding Style Questionnaire (CFSQ); b) to verify association between MPCW and child’ nutritional status; c) to describe the MFS; d) to verify differences between MPCW and child’s body mass index (BMI); e) and to verify the association between MPCW and MFS. Methods: 566 dyads participated (mother/preschool child). Mothers circle the image that more resembled their child (MPCW), and answered the CFSQ. Cronbach alpha coeffi cient was calculated. V Cramer, ANOVA and Chi-square were applied. Results: The internal consistency of CFSQ was 0.88. The 8.4% (n = 12) mothers of children are OW-OB had adequate MPCW (V = 0.26, p = 0.001). The most frequent MFS was authoritarian (34.5%, n = 195), MFS uninvolved presented the highest child’ BMI (F = 3.91, p < 0.05). When mothers perceive her child is OW-OB have a MFS uninvolved (χ2 = 15,384, df = 6, p < 0.05). Conclusions: Mothers of children with OW-OB have an inadequate MPCW and more frequently have a MFS authoritarian. When the mother perceive their child is OW-OB has MFS uninvolved. Interventions to help the mothers to recognize their child is OW-OB and teaching strategies that promote MFS authoritative are recommended.

Uninvolved Maternal Feeding Style Moderates the Association of Emotional Overeating to Preschoolers' Body Mass Index z-Scores

ObjectiveTo examine the relation between preschoolers' eating behaviors and body mass index (BMI) z-scores (BMIz) and the moderating role of permissive parent feeding styles in these associations. DesignCross-sectional study involving mothers' report of food-related parenting styles and child eating behaviors. SettingSmall city in southern Mississippi. ParticipantsMother–preschooler dyads (n = 104). Main Outcome MeasureChild body BMIz. AnalysisModerated multiple regression. ResultsAn uninvolved feeding style moderated the relationship between emotional eating and BMIz such that children with higher emotional overeating scores had higher a BMIz in the presence of an uninvolved feeding style (B = 2.16; P = .01). Conclusions and ImplicationsAn uninvolved feeding style may be a risk factor for higher BMIz in preschoolers who tend to overeat to cope with negative emotions. For other children in this population, self-regulatory aspects of eating may be more important than mothers' feeding style in the maintenance of healthy weight.

The influence of maternal psychosocial characteristics on infant feeding styles

Maternal feeding styles in infancy and early childhood are associated with children’s later risk for overweight and obesity. Maternal psychosocial factors that influence feeding styles during the complementary feeding period, the time during which infants transition from a milk-based diet to one that includes solid foods and other non-milk products, have received less attention. The present study explores how maternal psychosocial factors—specifically self-esteem, parenting self-efficacy, parenting satisfaction, and depression symptoms—influence mothers’ infant feeding styles at nine months of age, a time during which solid foods eating habits are being established. Participants included 160 low-income, African-American mother-infant pairs in central North Carolina who were enrolled in the Infant Care and Risk of Obesity Study. Regression models tested for associations between maternal psychosocial characteristics and pressuring and restrictive feeding styles. Models were first adjusted for maternal age, education, marital status and obesity status. To account for infant characteristics, models were then adjusted for infant weight-for-length, distress to limitations and activity level scores. Maternal self-esteem was negatively associated with pressuring to soothe. Maternal parenting self-efficacy was positively associated with restriction-diet quality. Maternal parenting satisfaction and depression symptoms were not associated with feeding styles in the final models. Focusing on strengthening maternal self-esteem and parenting self-efficacy may help to prevent the development of less desirable infant feeding styles.

Efecto de una intervención basada en guarderías para reducir conductas de riesgo de obesidad en niños preescolares

BackgroundPreschool age is a critical stage for health promotion and prevention of obesity, which is an emerging public health problem in children. The aim of this study was to design and evaluate the effect of a multifaceted intervention based on child-care centers to reduce risk behaviors for obesity among preschool children. MethodsA 12-month cluster-randomized community trial was conducted in 16 Mexican Institute of Social Security child-care centers in Mexico City. Children between 2 and 4 years of age enrolled in the selected child-care centers participated in the study. Intervention comprised 12 weekly curriculum sessions for the children, and six family workshops. Changes in children's dietary and physical activity, food availability at home, and maternal feeding styles were determined after 6 and 12 months. Changes within groups among stages, and between groups by stage were analyzed through χ2 test. ResultsThe intervention showed decrease of home availability for some non-recommended foods and increase in physical activity in the intervention group compared to the usual care group. ConclusionsImprovement in physical activity can be effective in the long term; innovative strategies aimed to modify family dietary risk behaviors are required.

Effect of an intervention based on child-care centers to reduce risk behaviors for obesity in preschool children

Abstract Background Preschool age is a critical stage for health promotion and prevention of obesity, which is an emerging public health problem in children. The aim of this study was to design and evaluate the effect of a multifaceted intervention based on child-care centers to reduce risk behaviors for obesity among preschool children. Methods A 12-month cluster-randomized community trial was conducted in 16 Mexican Institute of Social Security child-care centers in Mexico City. Children between 2 and 4 years of age enrolled in the selected child-care centers participated in the study. Intervention comprised 12 weekly curriculum sessions for the children, and six family workshops. Changes in children’s dietary and physical activity, food availability at home, and maternal feeding styles were determined after 6 and 12 months. Changes within groups among stages, and between groups by stage were analyzed through X2 test. Results The intervention showed a decrease of home availability for some non-recommended foods and an increase in physical activity in the intervention group compared to the control group. Conclusions Improvement in physical activity can be effective in the long term; innovative strategies aimed to modify family dietary risk behaviors are required.

Feeding Style and a Child's Body Mass Index

IntroductionEarly onset pediatric obesity has become a major health concern in the United States. A key contributing factor to early onset childhood is socialization to the eating and mealtime environment. Maternal feeding styles play an integral role in how children are socialized to the eating and mealtime environment. MethodThe study utilized a descriptive correlational research design. The sample was 126 mother/child dyads recruited from a southeastern Michigan Head Start program. Each mother completed a research packet. ResultsResults indicated that maternal beliefs such as nutritional belief and belief about the child's eating style were significantly associated with maternal feeding style. Maternal behaviors were associated with maternal feeding styles. DiscussionOverall, the study provides a description of maternal beliefs and behaviors related to the body weight status of a preschool-aged child.

Maternal Feeding Styles and Food Parenting Practices as Predictors of Longitudinal Changes in Weight Status in Hispanic Preschoolers from Low-Income Families.

Objective. The aim was to investigate the influence of feeding styles and food parenting practices on low-income children's weight status over time. Method. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) and again eighteen months later. At each time point, parents completed questionnaires and height and weight measures were taken on the child. Results. The indulgent feeding style (parent-report at baseline) was associated with increased child BMI z-score eighteen months later compared to other feeding styles. Authoritative, authoritarian, and uninvolved feeding styles were not significantly associated with increased child BMI z-score. Child BMI z-score at Time 1 (strongest) and maternal acculturation were positive predictors of child BMI z-score at Time 2. Maternal use of restriction positively predicted and maternal monitoring negatively predicted Time 2 BMI z-score, but only when accounting for feeding styles. Conclusion. This is the first study to investigate the impact of feeding styles on child weight status over time. Results suggest that indulgent feeding predicts later increases in children's weight status. The interplay between feeding styles and food parenting practices in influencing child weight status needs to be further explored.

Mother's Self-Efficacy Mediates the Relationship Between Household Food Insecurity and Maternal Infant Feeding Styles.

This study was performed to examine the association between household food insecurity, self-efficacy and infant feeding styles in mothers with children under 2 years old in Varamin, Iran. In this cross-sectional study, 423 mothers aged 17-40 years from different areas of Varamin were selected by a multistage sampling methods from October 2013 to February 2014. The questionnaires consisted of three valid instruments, including: Household Food Insecurity Access Scale, Comprehensive Feeding Practices Questionnaire and Mother's Self-Efficacy Questionnaire. Data were analyzed using Chi-square, t tests, ANOVA, Pearson correlations and multiple linear regressions. Structural equation modeling was also used. Mild and moderate-severe food insecurity was observed in 39.5 and 12.8 % of the households respectively. Mean score of mother's self-efficacy in food secure households was 32.5 ± 3.7; while in mild food insecure and moderate-severe food insecure households were 31.9 ± 3.1 and 28.4 ± 4.0, respectively (P = 0.001). There was a significant negative correlation between household food insecurity and mother's self-efficacy (r = -0.297, P < 0.01). Significant correlation was seen between mother's self-efficacy and the maternal infant feeding styles. Household food insecurity and mother's self-efficacy had significant relationship with mother-infant feeding styles: control of home food access [β (SE)] = [-0.015(0.004), P = 0.001]; restriction for weight control [β = 0.038(0.013), P = 0.003]; restriction for health [β = 0.019(0.008), P = 0.027] and encouragement [=0.018(0.006), P = 0.001]. The model had sufficient fitness with data of the research (CFI = 0.927, RMSEA = 0.076). Our findings suggest that performing interventions in order to enhance mother's self-efficacy in food insecure households can lead to improve positive maternal feeding behaviors.

학령전기 아동 체중에 대한 어머니의 인식과 자기 체형만족도 및 식이관리방식

학령전기 아동 체중에 대한 어머니의 인식과 자기 체형만족도 및 식이관리방식

Maternal Interactions with Young Children and Perceptions of Play with Toy Foods May Vary by Maternal Feeding Style

Maternal Interactions with Young Children and Perceptions of Play with Toy Foods May Vary by Maternal Feeding Style

Infant and maternal predictors of early life feeding decisions. The timing of solid food introduction

There is limited research on the maternal and infant characteristics associated with the timing of solid food introduction. The current study examined how maternal feeding style and infant temperament independently and interactively predicted the age at which infants were introduced to solid food. Data from 115 predominately white, middle-class mothers were collected when infants were 4 and 6 months of age. The timing of solid food introduction was positively correlated with mothers' age, education, breastfeeding at 4 months, self-reported responsiveness to infants' hunger and satiety cues, and negatively correlated with mothers' pre-pregnancy body mass index (BMI), beliefs about feeding infants solid food prior to 6 months of age, and infants' temperamental motor reactivity. When controlling for maternal age, education, pre-pregnancy BMI, and milk feeding method at 4 months, the timing of solid food introduction was negatively predicted by mothers' beliefs about feeding solid food prior to 6 months of age. Exploratory interaction analyses suggested that infant temperament marginally moderated maternal feeding style in predicting the timing of solid food introduction.

Tools for teen moms to reduce infant obesity: a randomized clinical trial.

BackgroundUnhealthy infant feeding practices, such as a combination of formula feeding and early introduction of solids may lead to rapid or excessive weight gain in early infancy. Adolescent mothers’ feeding behaviors are most directly related to infant weight gain in the first year of life. Compared to adult mothers, adolescent mothers are less knowledgeable, less responsive, more controlling, and less skilled in infant feeding, which interferes with infants’ healthy growth. The Tools for Teen Moms trial aims to compare the effect of a social media intervention for low-income adolescent, first-time mothers of infants 2 months of age or younger, versus standard care on infant weight, maternal responsiveness, and feeding style and practices. The intervention is conducted during the infant’s first four months of life to promote healthy transition to solids during their first year. Tools for Teen Moms is an intervention delivered via a social media platform that actively engages and coaches low-income adolescent mothers in infant-centered feeding to reduce rapid/excessive infant weight gain in the first six months of life.Methods/DesignWe describe our study protocol for a randomized control trial with an anticipated sample of 100 low-income African- American and Caucasian adolescent, first–time mothers of infants. Participants are recruited through Maternal-Infant Health Programs in four counties in Michigan, USA. Participants are randomly assigned to the intervention or the control group. The intervention provides infant feeding information to mothers via a web-based application, and includes daily behavioral challenges, text message reminders, discussion forums, and website information as a comprehensive social media strategy over 6 weeks. Participants continue to receive usual care during the intervention. Main maternal outcomes include: (a) maternal responsiveness, (b) feeding style, and (c) feeding practices. The primary infant outcome is infant weight. Data collection occurs at baseline, and when the baby is 3 and 6 months old.DiscussionExpected outcomes will address the effectiveness of the social media intervention in helping teen mothers develop healthy infant feeding practices that contribute to reducing the risk of early onset childhood obesity.Trial registrationClinical Trials.Gov NCT02244424, June 24, 2014

Bottle-feeding practices during early infancy and eating behaviors at 6 years of age.

Evidence suggests an association of breastfeeding with a maternal feeding style (MFS) that is less controlling than formula feeding, which, in turn, may improve a child's self-regulation of eating. This study examines associations of bottle-feeding practices during infancy with MFS and children's eating behavior (CEB) at 6 years old. We linked data from the Infant Feeding Practices Study II to the Year 6 Follow-Up, which include 8 MFS and CEB measures adapted from previous validated instruments. Bottle-feeding practices during the first 6 months estimated by using the Infant Feeding Practices Study II were bottle-feeding intensity (BFI), mother's encouragement of infant to finish milk in the bottle, and infant finishing all milk in the bottle. Adjusted odds ratios (aORs) for associations of bottle-feeding practices with MFS and CEB at 6 years old were calculated by using multivariable logistic regressions controlling for sociodemographic characteristics and other feeding practices (N = 1117). Frequent bottle emptying encouraged by mothers during infancy increased odds of mothers encouraging their child to eat all the food on their plate (aOR: 2.37; 95% confidence interval [CI]: 1.65-3.41] and making sure their child eats enough (aOR: 1.62; 95% CI: 1.14-2.31) and of children eating all the food on their plate at 6 years old (aOR: 2.01; 95% CI: 1.05-3.83). High BFI during early infancy also increased the odds of mothers being especially careful to ensure their 6-year-old eats enough. Bottle-feeding practices during infancy may have long-term effects on MFS and CEB. Frequent bottle emptying encouraged by mothers and/or high BFI during early infancy increased the likelihood of mothers pressuring their 6-year-old child to eat and children's low satiety responsiveness.

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study

BackgroundBecause early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This “parenting” intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT’s central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent–child responsibility for feeding, reducing subsequent risk for overeating and overweight.Methods/Design316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the “parenting” or “safety” groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3–4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic predictors of weight status. Finally, second-born siblings of INSIGHT participants will be enrolled in an observation-only study to explore parenting differences between siblings, their effect on weight outcomes, and carryover effects of INSIGHT interventions to subsequent siblings.DiscussionWith increasing evidence suggesting the importance of early life experiences on long-term health trajectories, the INSIGHT trial has the ability to inform future obesity prevention efforts in clinical settings.Trial registrationNCT01167270. Registered 21 July 2010.

Consistency in infants' behavioural signalling of satiation during bottle‐feeding

Understanding the dynamics of feeding is essential for preventing accelerated weight gain during infancy, a risk factor for obesity. Because infants satiate on larger volumes of cow milk formula (CMF) than CMF enriched with the free amino acid glutamate (CMF + glu), we used this model system to determine whether infants displayed consistent behaviours despite satiating on lower volumes. In this laboratory-based, within-subject experimental study of ≤4-month-old infants (n = 41) and their mothers, infants were videotaped while feeding to satiation CMF on one test day and CMF + glu on the other, in counterbalanced order. Each video-recording was analysed frame-by-frame for frequency and timing of behaviours. Infants' behaviours were consistent in types and frequency but were displayed sooner when feeding CMF + glu compared with CMF. The less responsive the mother's feeding style, the less consistent the infant displayed behaviours across the two formula meals (P = 0.05). Infants who spat up (a possible sign of overfeeding) consumed more formula (P = 0.01) and had less responsive mothers (P = 0.04) compared with the other infants. Infants are consistent in their behavioural displays during feeding at this developmental age. Regulation of intake and signalling of satiation during bottle-feeding are associated with formula composition and maternal feeding style.

Associations Between Maternal Feeding Style and Child Overweight

Previous research has identified numerous risk factors that are associated with the development of childhood obesity. In recent years, the possible role of parenting has also been explored, with the assumption made that parental control in the context of feeding may exert an influence on child eating and child weight. The aim of the present study was to explore whether parent feeding styles were associated with young children’s body mass index (BMI) and specifically if the authoritative style was predictive of a lower weight status. For this, 80 mother-child dyads were visited when children were 3 and 4 years old. Maternal feeding style was reported by the mothers at the 3-year visit, and children’s anthropometric measurements were made at 3 and 4 years. Although not different across groups at 3 years, children whose mothers reported an authoritative feeding style had the lowest mean BMI percentile scores at ages 3 and 4 years. Although the subgroup of children of authoritarian mothers showed a significant increase in their BMI percentile scores from 3 to 4 years, the children of indulgent mothers had the highest BMI percentile scores at 4 years. The results of this study suggest that an indulgent maternal feeding style may be a risk factor for children’s unrestricted eating and becoming overweight.

Maternal feeding styles and preschool children’s influence of sugar‐sweetened beverages and fruit juice purchases (379.2)

Parental feeding styles have been associated with child weight status and food intake and may also be related to the extent of child influence on maternal purchasing behaviors. The purpose of the study was to examine the association of maternal feeding styles with preschool children’s influence on maternal purchases of sugar‐sweetened beverages (SSB: juice drinks, soda, and sports drinks) and fruit juice (FJ) in low‐income families. This was a cross‐sectional study of 200 mothers in Oklahoma City. Participants provided demographic information, frequency of co‐shopping with the child, and child purchasing influence of SSB and FJ. Feeding styles were assessed with the Caregiver Feeding Styles Questionnaire based on demandingness and responsiveness (low: 1, high: 5). Mothers were 52% African‐American and 20% Latino. Maternal demandingness (mean ± SD) was 2.61 ± 0.65, and responsiveness was 1.25 ± 0.19. Mothers reported more frequent influence by their child to help select and purchase SSB compared to FJ (p&lt;0.05). Further, child influence for FJ purchases was associated with maternal responsiveness (r =0.17, p=0.014) while no significant associations existed with SSB. Higher responsiveness indicated a mother’s willingness to allow the child to help her select FJ to purchase more often. High maternal responsiveness may allow the child to influence selection of healthier beverage options.

Feeding Styles and the Body Weight Status of Preschool-aged Children

Early-onset pediatric obesity has become a major health concern in the United States. One of the key contributing factors to early-onset childhood obesity is how children are socialized to the eating and mealtime environment. The purpose of this study was to determine the extent to which maternal feeding styles influenced the child's actual weight. The study used a descriptive correlational research design. Ten pediatric experts classified the authoritative feeding style as healthy. The maternal behavior of the authoritative feeding style was significantly associated with healthy behaviors in the child.

NURTURE: Development and pilot testing of a novel parenting intervention for mothers with histories of an eating disorder

To describe the treatment development and pilot testing of a group parenting intervention, NURTURE (Networking, Uniting, and Reaching out To Upgrade Relationships and Eating), for mothers with histories of eating disorders. Based on focus group findings, extant research, and expert opinion, NURTURE was designed to be delivered weekly over 16 (1.5 h) sessions via an interactive web conferencing forum. It comprises four modules: (1) laying the foundation, (2) general parenting skills, (3) eating and feeding, and (4) breaking the cycle of risk. Pilot testing was conducted with three groups of 3-6 mothers (N = 13) who had children ages 0-3 years to determine feasibility (e.g., retention), acceptability (e.g., feedback questionnaire responses), and preliminary efficacy. Maternal satisfaction with NURTURE and changes in mother-child feeding relationship measures, maternal feeding style, maternal self-efficacy, and maternal psychopathology (eating disorder, depression, and anxiety symptoms) across three time points (baseline, post-treatment, 6-month follow-up) were examined. All outcomes were exploratory. The intervention was well tolerated with a 100% retention rate. Feedback from mothers was generally positive and indicated that the groups provided an engaging, supportive experience to participants. We observed changes suggestive of improvement in self-reported maternal self-efficacy and competence with parenting. There were no notable changes in measures of maternal feeding style or psychopathology. NURTURE is a feasible, acceptable, and potentially valuable intervention for mothers with eating disorder histories. Results of this pilot will inform a larger randomized-controlled intervention to determine efficacy and impact on child outcomes.