Non-responsive Feeding Practices Research Articles

Indian fathers’ perceptions of young childcare and feeding – A qualitative study

The role of parents in fostering children's healthy habits is a robust area of research. However, most of the existing literature predominantly focuses on mothers' parenting practices. Given the emergence of nuclear, dual earning families and the recent surge in maternal employment in urban India, fathers' engagement in child rearing and feeding warrants attention. The purpose of this research was to document the views of Indian fathers about paternal parenting practices, with an emphasis on children's diet among other health behaviors. Thirty-three fathers of children aged 6–59 months from Kolkata, India took part in semi-structured interviews conducted either face-to-face or over Zoom/telephone in Hindi, Bengali, and English. The interviews were audio recorded, transcribed verbatim, and translated to English. The transcribed data were subjected to thematic analysis informed by the Template Analysis technique. Themes were detected using the NVivo software program. Overall, these Indian fathers played an important role in early childhood care and feeding as reflected in the following seven themes: (i) Involvement of fathers in various childcare activities; (ii) Implementation of responsive and non-responsive feeding practices; (iii) Concerns regarding fussy and slow eating; (iv) Concerns regarding excessive screen time; (v) Paternal vs maternal parenting; (vi) Barriers to routine engagement of fathers in childcare; (vii) Desire for more nutrition and health knowledge. This enhanced understanding of paternal parenting behavior supports the inclusion of fathers in future family-focused lifestyle interventions aimed at improving children's health outcomes, including their dietary habits.

Utilising online paradigms to explore the effect of boredom and sadness on children's snack choice: The role of parental feeding practices and child temperament

Emotional eating (EE) is defined as eating in response to negative emotions (e.g., sadness and boredom). Child temperament and parental feeding practices are predictive of child EE and may interact to shape child EE. Previous research has demonstrated that children eat more when they are experiencing sadness, however, boredom-EE (despite how common boredom is in children) has yet to be explored experimentally using remote methodologies. The current study explores whether feeding practices and child temperament interact with mood to predict children's snack selection in an online hypothetical food choice task. Using online experimental methods, children aged 6-9-years (N = 347) were randomised to watch a mood-inducing video clip (control, sadness, or boredom). Children completed a hypothetical food choice task from images of four snacks in varying portion sizes. The kilocalories in children's online snack choices were measured. Parents reported their feeding practices and child's temperament. Results indicated that the online paradigm successfully induced feelings of boredom and sadness, but these induced feelings of boredom and sadness did not significantly shape children's online food selection. Parental reports of use of restriction for health reasons (F = 8.64, p = .004, n2 = 0.25) and children's negative emotionality (F = 6.81, p = .009, n2 = 0.020) were significantly related to greater total kilocalorie selection by children. Three-way ANCOVAs found no evidence of any three-way interactions between temperament, feeding practices, and mood in predicting children's online snack food selection. These findings suggest that children's hypothetical snack food selection may be shaped by non-responsive feeding practices and child temperament. This study's findings also highlight different methods that can be successfully used to stimulate emotional experiences in children by using novel online paradigms, and also discusses the challenges around using online methods to measure children's intended food choice.

Complementary feeding practices for children aged 6-23 months in early childhood education institutions in urban China: A cross-sectional study.

Appropriate infant and young child feeding (IYCF) plays a crucial role in promoting the healthy growth of children. Currently, many Chinese urban parents are seeking care of children from the early childhood education (ECE) institutions, however, little is known about the feeding practices of infants and young children in ECE institutions. This study aims to investigate the complementary feeding practices for Chinese urban children aged 6-23 months in ECE institutions and explore potential factors influencing their feeding practices. This cross-sectional study was conducted among primary caregivers of children aged 6-23 months in ECE institutions across 31 provinces in China from 1 March to 30 April 2023. Convenience sampling was used to recruit caregivers from centres of Gymboree Play & Music (an ECE institution). Self-administered questionnaires were designed using the online survey tool Sojump and distributed through WeChat platform, which collected information on 1) children's complementary feeding practices; 2) food frequency of seven food groups; 3) caregivers' feeding knowledge and practices; 4) frequency of children attended ECE classes and the primary caregivers' daily nurturing care time; 5) source of information on complementary feeding. A total of 2731 children and their caregivers were surveyed, with 416 children aged 6-11 months and 2315 children aged 12-23 months. The prevalence of minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) was 59.4, 60.6, and 39.2%, respectively. Only 17.3% caregivers believed that continued breastfeeding should be at two years or above, and 29.5% children were continuously breastfed at 12-23 months (CBF). The proportion of non-responsive feeding practices among caregivers ranged from 28 to 64%. Except for CBF, the prevalence of other key complementary feeding practices was higher among children who attending ECE classes than those not attending ECE classes (all P < 0.05). Moreover, children aged 12-23 months who received long-nursing care time (≥4h/d) had significantly higher MMF and MAD prevalence than those in short-nursing care time group (MMF = 66.2 vs. 58.8%, P = 0.0003; MAD = 44.2 vs. 38.3%, P = 0.0047). The complementary feeding practices of children aged 6-23 months in ECE institutions in urban China remained suboptimal, and non-responsive feeding practices among caregivers were common. The attendance of ECE classes and the caregivers' daily nurturing care time could be beneficial in ensuring children to comply with complementary feeding recommendations.

Prospective associations between early childhood parental feeding practices and eating disorder symptoms and disordered eating behaviors in adolescence.

Nonresponsive parental feeding practices are associated with poorer appetite self-regulation in children. It is unknown whether this relationship extends beyond childhood to be prospectively associated with the onset of eating disorder (ED) symptoms in adolescence. This exploratory study therefore investigated prospective associations between early childhood parental feeding practices and adolescent ED symptoms and disordered eating behaviors. Data were from two population-based cohorts with harmonized measures: Generation R (Netherlands; n = 4900) and Gemini (UK; n = 2094). Parents self-reported their pressure to eat, restriction and instrumental feeding (i.e., using food as a reward) at child age 4-5 years. Adolescents self-reported their compensatory behaviors (e.g., fasting, purging), binge-eating symptoms, restrained eating, uncontrolled eating, and emotional eating at 12-14 years. Associations between feeding practices and ED symptoms were examined separately in each cohort using generalized linear models. In Gemini, pressure to eat in early childhood was associated with adolescents engaging in compensatory behaviors. In Generation R, parental restriction was associated with adolescents engaging in compensatory behaviors, restrained eating, uncontrolled eating, and emotional eating. Instrumental feeding was associated with uncontrolled eating and emotional eating in Generation R. Nonresponsive parental feeding practices were associated with a greater frequency of specific ED symptoms and disordered eating in adolescence, although effect sizes were small and findings were inconsistent between cohorts. Potentially, the cultural and developmental context in which child-parent feeding interactions occur is important for ED symptoms. Further replication studies are required to better understand parents' role in the development and maintenance of ED-related symptoms. Prospective research examining how early childhood parental feeding practices might contribute to adolescent ED symptoms is limited. In two population-based cohorts, nonresponsive feeding practices (restriction, instrumental feeding, pressure to eat) predicted increased frequency of some ED symptoms and disordered eating behaviors in adolescence, although associations were small and further replication is required. Findings support the promotion of responsive feeding practices, which may benefit young children's developing relationship with food.

Bidirectional Associations between Parental Feeding Practices and Child Eating Behaviors in a Chinese Sample.

Child eating behaviors (CEBs) and parental feeding practices (PFPs) play critical roles in childhood obesity. However, the bidirectional relationships between CEBs and PFPs remain equivocal. This longitudinal study aimed to explore their bidirectional relationships. A convenience sample of 870 parents with preschoolers was recruited in this longitudinal study (Shanghai, China). Three non-responsive feeding practices (NFPs), three responsive feeding practices (RFPs), five CEBs, and covariates were collected using validated questionnaires at baseline and the 6-month follow-up. Cross-lagged analyses using structural equation modeling (SEM) were performed to examine their bidirectional relationships. Eight hundred and fifty-three parents completed questionnaires, with a response rate of 98%. The mean age of their children at baseline was 4.39 years (standard deviation = 0.72 years). Eighteen out of sixty longitudinal cross-lagged paths were statistically significant. Parental encouragement of healthy eating and content-restricted feeding were found to be bidirectionally associated with child food fussiness. Four parent-driven associations and one child-driven association were identified between RFPs and CEBs. For example, monitoring was negatively associated with children's unhealthy eating habits (β = -0.066, standard error (SE) = 0.025, p < 0.01). Eight child-driven associations and one parent-driven association were observed between NFPs and CEBs. For example, higher child satiety responsiveness predicted a higher pressure to eat (β = 0.057, SE = 0.029, p < 0.01) and the use of food as a reward (β = 0.083, SE = 0.031, p < 0.01). There were bidirectional, parent-driven, and child-driven associations. Parents should be encouraged to adopt RFPs to shape CEBs. Increasing parents' understanding of CEBs and providing them with reasonable coping strategies would help optimize PFPs.

Validation of the Comprehensive Feeding Practices Questionnaire (CFPQ) with Portuguese Caregivers of 2-to-8-Year-Olds.

Recent findings have demonstrated an increase in the prevalence of childhood obesity and overweight in Portugal, urging the need to study modifiable risk factors such as parental feeding practices. The Comprehensive Feeding Practices Questionnaire (CFPQ) is an important self-report measure assessing a broad range of responsive and non-responsive feeding practices. However, the CFPQ has not yet been validated in Portugal. Therefore, the present study aimed to test the validity of this measure with Portuguese parents of 2-to-8-year-old children. A sample of 409 parents completed a Portuguese-adapted version of the CFPQ and the already validated Child Feeding Questionnaire (CFQ). Confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and psychometric analysis were conducted. CFA demonstrated the original 12-factor structure did not fit the sample. EFA identified an eight-factor structure comprising 29 items: Monitoring, Modeling, Environment, Involvement, Emotion Regulation, Restriction for Weight Control, Restriction for Health, and Pressure. Findings suggest that parental feeding practices are sensitive to parents' background cultures and children's developmental period.

Emotional eating following a laboratory mood induction: The interaction between parental feeding practices and child temperament

Children who emotionally eat (EE) tend to consume palatable foods that are high in sugar and fat. How EE develops remains unclear, but children’s temperament and parental feeding practices may interact to shape child EE. To date, no research has explored these interaction effects on EE experimentally. Furthermore, most research has explored EE in response to generic ‘negative’ mood rather than specific negative emotions, such as boredom, which has never been explored in this context. This study aimed to explore interactions between induced mood condition (sadness, boredom, control), parent-reported non-responsive feeding practices and parent-reported child temperament (negative affect, surgency, effortful control) in predicting kilocalories consumed by children aged 4–5-years in a laboratory setting. Using three-way ANOVA, the interactions between mood state, parental feeding practice and child temperament were assessed. Results indicated that children who experienced boredom consumed significantly more total kilocalories than children in the control condition. Additionally, children with high negative affect who also had parents who reported high use of food for emotion regulation consumed significantly more kilocalories from sweet food when experiencing boredom compared to control condition, and children with high negative affect who also had parents who reported low use of food as a reward consumed significantly more kilocalories from sweet food when experiencing boredom compared to control condition. These findings suggest that feelings of boredom differentially predict children’s snack food intake, and that child negative affect and non-responsive feeding practices play an important role in the expression of this relationship.

Maternal mood, body image, and eating habits predict changes in feeding practices during the COVID-19 pandemic

Maternal mood and eating habits are associated with food parenting practices, including non-responsive feeding practices, which in turn impact children's eating habits. The COVID-19 pandemic may have negatively impacted maternal mood due to the overall stress and challenges, contributing to changes in eating behaviors and food parenting practices. The present study examined how maternal mood, body image, and eating concerns were related to perceived changes in feeding practices during the pandemic. A total of 137 mothers participated in an online study. Participants retrospectively reported their mood, eating habits, body dissatisfaction, and non-responsive feeding practices, before and during the pandemic, and responded to open-ended questions regarding changes in eating and feeding patterns during the pandemic. Results suggested differences in non-responsive feeding practices, including higher use of food as a reward for behavior and lower use of standard meal settings during the pandemic. In addition, significant relationships were found between higher maternal stress and higher body dissatisfaction (r = 0.37; p < .01), restrained eating (r = 31; p < .01), emotional eating (r = 0.44; p < .01), and higher use of overt and covert restriction retrospectively and during the pandemic. Results revealed trends in the same direction for depression and anxiety. Finally, qualitative findings were consistent with the quantitative findings, suggesting relationships between maternal mood, eating habits, and feeding practices. These results provide support for previous findings suggesting that the pandemic negatively impacted maternal well-being, increasing the use of some non-responsive feeding practices. Further work exploring the impacts of the pandemic on well-being, child feeding, and eating patterns is warranted.

Associations between Emotion Regulation, Feeding Practices, and Preschoolers' Food Consumption.

Previous research identified emotion dysregulation, non-responsive feeding practices, and unhealthy food consumption as risk factors for childhood obesity. However, little is known about the relationships between these factors. This study examined associations between children’s emotion regulation, parental feeding practices, and children’s food consumption. The sample consisted of 163 mothers of children aged 3–5 years. Mothers completed the Emotion Regulation Checklist, the Child Feeding Questionnaire, and the Child Health Section from the Parent Interview of the Early Childhood Longitudinal Study-B to assess model variables. Results showed that healthy food consumption was associated with higher emotion regulation abilities, higher monitoring, and lower pressure to eat. For unhealthy food consumption, the associations were in opposite directions. Higher emotion regulation abilities were also associated with higher monitoring, lower pressure to eat, and lower restriction. For lability, the associations were in opposite directions. Regression analyses revealed that children’s lability, pressure to eat, and monitoring were significant predictors of children’s food consumption. These findings suggest that children’s emotion regulation and feeding practices are important determinants of children’s food consumption. Future longitudinal studies that examine bidirectional associations between children’s emotion regulation, parental feeding practices, children’s food consumption, and potential mechanisms accounting for these associations are needed.

Mental health matters: Parent mental health and children's emotional eating

Parents' symptoms of anxiety and depression are associated with their increased likelihood of using nonresponsive feeding practices and with children's elevated obesity risk. These feeding practices, particularly persuasive-controlling feeding practices, have further been linked to children's emotional eating, including both emotional overeating and undereating. To help future research identify points of interventions to reduce children's maladaptive eating behaviors, the goal of this study was to determine whether persuasive-controlling feeding practices mediated the link between parent mental health and children's emotional eating. Feeding practices were measured by the FPSQ. Anxiety was measured by the GAD-7. Depression was measured by the CESD-R. Emotional eating was measured by the CEBQ. Survey data were collected from 259 U.S. parents of preschool children as a part of a larger study. Results from structural equation modeling showed that nonresponsive feeding behaviors mediated the relationship between parent mental health and children's emotional eating. Future longitudinal studies and clinical trials should examine whether and how persuasive-controlling feeding practices explain the link between parents' mental health and children's maladaptive eating behaviors, including emotional eating.

The Relationships between Caregivers' Concern about Child Weight and Their Non-Responsive Feeding Practices: A Systematic Review and Meta-Analysis.

Background: It is unclear whether caregivers’ concern about child weight impacts their non-responsive feeding practices. This systematic review aimed to examine their relationships. Methods: A systematic search of PubMed, Embase, PsycINFO, Web of Science core collection, CINAHL and grey literature was conducted from inception to March 2022, following PRISMA guidelines. Data synthesis was performed using a semi-quantitative approach and a meta-analysis. Results: A total of 35 studies with 22,933 respondents were included in the review for semi-quantitative analyses. Thirty-four studies examined 52 associations between concern about child weight and restriction with 40 statistically significant associations being observed. A total of 34 relationships between concern about child weight and pressure to eat were investigated, with 12 being statistically significant. The pooled regression coefficients (β) demonstrated that caregivers’ concern about child overweight was positively associated with restriction (β = 0.22; 95%CI: 0.12, 0.31), negatively associated with use of food as a reward (β = −0.06; 95%CI: −0.11, −0.01), and not statistically associated with pressure to eat (β = −0.05; 95%CI: −0.13, 0.04). The pooled odds ratios (ORs) indicated that caregivers who were concerned about child overweight were found to use restrictive feeding more often (OR = 2.34; 95%CI: 1.69, 3.23), while less frequently adopting pressure to eat (OR = 0.76; 95%CI: 0.59, 0.98) compared with those without concerns. The results also showed that caregivers who were concerned about child underweight were more likely to force their children to eat (OR = 1.83; 95%CI: 1.44, 2.33) than those without concerns. Conclusion: Caregivers’ concern about child weight may be an important risk factor for non-responsive feeding practices. Thus, interventions are needed to focus on managing and relieving caregivers’ excessive concern about child weight, especially overweight, which may optimize feeding practices and subsequently contribute to child health.

Infant and Young Child Feeding Perceptions and Practices Among Caregivers Living in Three Districts in the Central Region of Ghana

ObjectivesThis qualitative study sought to understand caregiver practices related to exclusive breastfeeding (EBF), meal frequency, diet diversity, and responsive feeding in rural communities in Ghana. MethodsFifty-two audio-taped in-depth interviews were conducted in local dialects with caregivers (teen and adult mothers, fathers, and grandmothers) of children younger than 1-year-old living in three districts in Ghana’s Central Region. Recordings were translated, transcribed into English, then read and coded independently by two authors. Consensus was reached on emerging domains and themes, and a final codebook was developed. ResultsCaregivers were knowledgeable about EBF and complementary feeding recommendations. However, preliminary findings showed that non-adherence to EBF was common. Water was fed to address perceived thirst and/or to soothe persistent crying. Perceived readiness for complementary foods was tied to the belief that, by 3–6 months, breastmilk could not satisfy hunger. From the sixth month, infants were fed at least three times, including night feeds, and perceived to be capable of eating any family foods if home prepared soft and not spicy. Caregivers understood that local proteins such as pounded dried fish could be added to soups and stews while egg yolk could be added to porridge. Responsive and non-responsive feeding practices emerged. Meals were fed using spoons, cups, and bowls, and caregivers constantly engaged and interacted with the child (cooing) to encourage eating. Caregivers were aware that introducing new foods may require several tries before acceptance and recommended patience and encouragement when offering new foods. Caregivers typically used time of day and incessant crying to recognize hunger, not knowing how to identify subtle hunger cues. Some misperceptions about early foods centered around illness, especially stomach aches and diarrhea, and how those might be a result of late night feeding or sugary foods/snacks. ConclusionsGaps were seen between caregiver knowledge of feeding recommendations and some infant and young child (IYCF) perceptions/practice. Caregivers in this population may benefit from targeted IYCF counseling to facilitate optimal caregiver practices. Funding SourcesThis study was funded by UNICEF-Ghana.

Bidirectional Associations between Parental Non-Responsive Feeding Practices and Child Eating Behaviors: A Systematic Review and Meta-Analysis of Longitudinal Prospective Studies.

Background: Parental non-responsive feeding practices and child eating behaviors both play significant roles in childhood obesity. However, their longitudinal relationships are less clear. This systematic review aimed to examine their bidirectional associations. Methods: A systematic search of five databases was conducted from inception to February 2022. Data synthesis was performed using a semi-quantitative and quantitative approach. Results: A total of 14 studies with 15348 respondents were included. A total of 94 longitudinal effects from 14 studies of parental non-responsive feeding practices on child eating behaviors were investigated, and 19 statistically significant effects were discovered. Seventy-seven longitudinal effects from nine studies of child eating behaviors on parental feeding practices were examined, with fifteen being statistically significant. The pooled results of meta-analysis showed five statistically significant associations: parental restrictive feeding positively predicted child enjoyment of food (β = 0.044; 95% CI: 0.004, 0.085); use of food as a reward positively predicted child emotional eating (β = 0.09; 95% CI: 0.04, 0.15); child food responsiveness positively predicted restrictive feeding (β = 0.04; 95% CI: 0.02, 0.06); use food as a reward (β = 0.06; 95% CI: 0.03, 0.10). In addition, the pooled effects showed that child satiety responsiveness negatively predicted restrictive feeding (β = −0.05; 95% CI: −0.08, −0.01). Conclusions: The bidirectional relationships between parental non-responsive feeding practices and child eating behaviors are inconsistent and a few showed statistical significance. Theory-driven longitudinal studies using validated instruments and controlling for potential confounders are needed to unveil their relationships and provide evidence for obesity prevention interventions.

RAISE (Raising Infants to Be Smart Eaters) Pilot Study.

Background: Many of the complex determinants of obesity originate during infancy when small changes in the environment can permanently influence appetite, behavior, and energy metabolism. Parent feeding style ("how" rather than "what" to feed) has emerged as a potentially important factor in early obesity prevention. Objectives: (1) To assess the feasibility of conducting a brief responsive feeding education intervention by public health nurses during routine well-baby visits. (2) To assess whether this intervention affects parents' attitudes and behavior related to responsive feeding. Methods: Prospective, nonrandomized, comparative pilot study conducted in two communities. Intervention participants were exposed to enhanced responsive feeding education by public health nurses at routine well-baby visits from 0 to 18 months along with wall posters, handouts, automated text messages and tangible takeaways. Parent knowledge and behavior were measured using the Infant Feeding Style Questionnaire and the Toddler Development Index. Feasibility and acceptability were assessed by patients and nurses through open text feedback forms and mid-point and exit interviews. Results: Recruitment (18 intervention; 9 control) and retention fell below targets. Average adherence to protocol by nurses from 0 to 12 months was 89%. Delivery of the intervention was feasible and acceptable, but the additional research-related tasks were challenging in a busy clinical setting. Parents found the different formats and information new and helpful. There was a trend toward less nonresponsive (pressuring, restrictive, laissez-faire) feeding practices in the intervention group. Conclusions: This pilot study demonstrated encouraging results related to overall feasibility and effect on parent feeding style.

A thematic cluster analysis of parents' online discussions about fussy eating.

Food fussiness is associated with non‐responsive parent feeding practices, such as persuasive and instrumental feeding. Although most children described as ‘fussy eaters’ are likely exhibiting developmentally typical behaviours, up to half of the parents of children 2–5 years old express concerns. Concern for fussy eating may mediate the use of non‐responsive feeding practices and so must be addressed in parent feeding interventions. Therefore, it is critical to better understand parents' concerns and how they may relate to feeding practices. This study aimed to explore how parents' feeding practices and the social cognitive factors that may drive them clustered based on parents' concern for fussy eating. Data were collected from parent discussions of fussy eating on a Reddit forum (80,366 posts). Latent Dirichlet allocation was used to identify discussions of fussy eating. Relevant posts (1542) made by users who identified as a parent of a fussy eater (n = 630) underwent qualitative coding and thematic analysis. Five clusters of parents were identified, ranging in size from 53 to 189 users. These were primarily characterised by parents' degree of concern and feeding practices: (1) High concern, nonresponsive; (2) Concerned, nonresponsive; (3) Low concern, responsive; (4) Low concern, mixed strategies; (5) Low concern, indulgent. Parents who used responsive practices tended to be less concerned for fussy eating, have greater trust in their child's ability to self‐regulate hunger, have longer‐term feeding goals, and exhibit greater ability for personal self‐regulation. Future research should further examine how these constructs may be leveraged in parent feeding interventions.

Groups of mothers based on feeding practices and their associations with dietary quality of pre-school children: A latent profile analysis

Parents' feeding practices are associated with children's food intake. However, little is known about the patterns of feeding practices used by groups of mothers or how these groupings of practices influence children's dietary intake. Therefore, the aims of this study are to classify and describe groups of mothers according to their patterns of feeding practices and to examine the associations between the groups of maternal feeding practices and pre-school children's dietary quality.In 2018, 1349 mothers based in Australia of children aged 2–5 years completed an online survey including validated measures of nine feeding practices and dietary quality, measured using thirteen summed dietary items. Latent profile analysis was used to identify distinct groups of mothers who shared similar feeding practices. Linear regression models were fitted to examine associations between the feeding practice profiles and child dietary quality.A three-profile model was chosen based on interpretation, profile size and statistical model fit criteria. Profile 1 had lower mean scores of structure-related feeding practices than the other profiles; profile 2 had mean scores reflecting slightly higher use of most structure-related feeding practices and lower mean scores of some non-responsive feeding practices; profile 3 had higher mean scores of non-responsive feeding practices than the other profiles. Profile 1 (−2.95, CI: 3.97; −1.92) and profile 3 (−2.81, CI: 3.49; −2.13) had lower mean child dietary quality scores compared with profile 2.Profile 2, which reflected the most engagement in structure-related feeding practices combined with least non-responsive feeding practices, was associated with higher child diet quality, compared with the other two profiles. The identification of these unique profiles could help to tailor future interventions to consider patterns of feeding practices used by groups of mothers.

The relationship between COVID-related parenting stress, nonresponsive feeding behaviors, and parent mental health.

COVID-19 has disrupted the lives of families across the United States and all over the world. Stress is known to have a negative impact on parent–child feeding interactions; hence, the purpose of this study is to examine how COVID-related parenting stress, which was measured using a newly developed scale, is related to parent mental health, nonresponsive feeding, and children’s self-regulation of eating. 119 parents of children ages 2–7 years old filled out questions about COVID-related parenting stress, mental health, nonresponsive feeding behaviors, and children’s self-regulation of eating. A series of multiple regressions were run to predict parent anxiety and psychological distress from COVID-related parenting stress. COVID-related parenting stress was found to be a significant predictor of both parent anxiety and psychological distress. When COVID-related parenting stress was further broken down into COVID-Related Job/Financial Security Stress and COVID-Related Family Safety/Stability Stress, COVID-Related Job/Financial Security Stress predicted psychological distress while COVID-Related Family Safety/Stability Stress predicted parent anxiety. Moderation analyses were also run to test the difference across the parents of children under 5 years of age and those of children who were 5 years of age and older regarding the association of COVID-related parenting stress and either parent anxiety or psychological distress. There was no significant difference across age. Lastly, COVID-related parenting stress and nonresponsive feeding practices were simultaneously entered into a multiple regression to predict children’s self-regulation of eating, and COVID-related parenting stress and parent distrust in appetite were both found to decrease children’s ability to self-regulate energy intake. Based on findings from this study, researchers interested in improving children’s self-regulation of eating and long-term health outcomes should continue to target the reduction of nonresponsive parent feeding behaviors, but they should also aim to look beyond specific parent feeding behaviors by attempting to help parents manage stressors in their lives.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12144-021-02333-y.

Caregivers' Perceived Emotional and Feeding Responsiveness toward Preschool Children: Associations and Paths of Influence.

Although there is a large body of research connecting emotion to eating behaviors, little is known about the role of caregivers’ responses to children’s emotions in the context of child feeding. The purpose of this study was to analyze the relation between caregivers’ emotional responsiveness and feeding responsiveness. The mothers of 137 children between 2 and 6 years of age reported on their responses to children’s negative emotions using the Coping with Children’s Negative Emotions Scale and on their feeding practices using the Comprehensive Feeding Practices Questionnaire. The results showed that mothers’ supportive emotion responses (e.g., problem-focused, emotion-focused, and expressive encouragement reactions) tend to be positively associated with responsive feeding practices (e.g., encouraging, modelling, and teaching healthy food-related behaviors). Instead, mothers’ unsupportive responses (e.g., distress, punitive and minimization reactions) tend to be positively associated with nonresponsive feeding practices (e.g., food as reward or to regulate emotions, and pressure to eat) and negatively associated with responsive feeding practices. Our results suggest that emotional and feeding responsiveness may be intertwined and that differences in parent’s emotional responsiveness may translate into differences in their feeding styles, setting the stage for parents’ use of positive vs. negative feeding practices.

Comparison of Early Feeding Practices in Mother-Father Dyads and Possible Generalization of an Efficacious Maternal Intervention to Fathers' Feeding Practices: A Secondary Analysis.

To compare feeding practices within mother–father dyads and explore whether outcomes of an efficacious intervention for mothers generalised to fathers’ feeding practices. The NOURISH RCT evaluated an early feeding intervention that promoted positive feeding practices to support development of healthy eating habits and growth. The intervention was delivered to first-time mothers via 2 × 12 week modules commencing when children were 4 and 14 months. Mothers self-reported feeding practice outcomes at child age 2 years using validated scales (1 = low to 5 = high) from the Child Feeding Questionnaire (CFQ). Nine months later, an independent cross-sectional descriptive study to investigate fathers’ feeding practices was initiated. Fathers were recruited by contacting (via letter) mothers participating in two pre-existing studies, including the NOURISH trial. Fathers completed a feeding practices questionnaire, similar to that used for NOURISH outcome assessments. Seventy-five fathers recruited via the NOURISH cohort (21% response) returned questionnaires. Response data from this subset of fathers were then linked to the corresponding NOURISH maternal data. Complete data were available from 70 dyads. Compared with mothers, fathers self-reported higher concern about child overweight (2.2 vs. 1.3), restriction (3.6 vs. 2.9) and pressure (2.6 vs. 2.1), all p < 0.001. Fathers whose partners were allocated to the intervention group used less pressure (mean difference 0.46, p = 0.045) and were more willing to let the child decide how much to eat (−0.51, p = 0.032). Fathers’ higher concern about child weight and more frequent use of non-responsive feeding practices, when compared with mothers, identify them as potentially potent contributors to child feeding. This preliminary evidence for modest generalisation of an efficacious maternal intervention to apparent effects on some paternal feeding practices speaks to the importance and promise of including fathers in early feeding interventions.

Non-responsive feeding practices mediate the relationship between maternal and child obesogenic eating behaviours

Both genetic and environmental influences underpin complex multidimensional associations between maternal and child eating behaviours, maternal feeding practices and child obesity risk. The aim of the present study was to explore cross-sectional relationships between maternal and child eating behaviours, and to examine whether maternal feeding practices mediate these relationships. Data were available from 478 Australian mothers (M = 38.8 years, SD = 5.6) of a 5–10 year old child (M = 7.0 years, SD = 1.1; 48.2% male). Mothers completed an online survey that included validated measures of maternal eating behaviours, maternal feeding practices and child eating behaviours. Maternal emotional overeating and food responsiveness, were each positively associated with the parallel child eating behaviour (r = 0.29 and r = 0.21, ps < .001, respectively). Mediation analyses showed that both the relationship between maternal and child emotional overeating and between maternal and child food responsiveness, were partially mediated by use of food as a reward and overt restriction (total indirect effect: .04, 95% CI 0.02, 0.07 and 0.82, 95% CI 0.04, 0.13, respectively). Findings suggest a role for feeding practices in explaining the concordance between maternal and child eating behaviours. Moreover, the results highlight the need for interventions that support parents to recognise these eating behaviours in themselves and their children and understand how these may potentially influence the feeding practices they use. Future longitudinal research that confirms the cross-sectional relationships between maternal and child eating behaviours and feeding practices reported here will strengthen the evidence to support the importance of feeding practices in the development of dietary intake patterns and obesity risk.