Parental Feeding Strategies Research Articles

Examining the whole plate: The role of the family context in the understanding of children's food refusal behaviors

Introduction: In the context of understanding children's food refusal behaviors, such as food fussiness and food neophobia, research has predominantly focused on the role of parental feeding strategies. However, little is known about which general family context variables add to the understanding of children's food refusal behaviors. The purpose of this study was to examine the relation between 1) parents' own use of maladaptive emotion regulation strategies when they are anxious, 2) parents' reactions towards their children's emotions in stressful situations, and 3) parenting styles on the one hand, and children's food refusal behaviors on the other. Methods: Mothers and fathers (N = 157) of young children (M = 4.64, SD = 1.7) completed a series of self- and parent-report questionnaires. Results: The model examining the role of parenting styles was found to be significantly related to food refusal behaviors in children. More specifically, the current findings demonstrate that higher levels of a coercive parenting style were associated with higher levels of both food fussiness and food neophobia in children. Furthermore, higher levels of a chaotic parenting styles were associated with higher levels of food neophobia in children. The models examining parents' maladjusted emotion regulation strategies when anxious and parents' reactions towards their children's emotions during stressful situations were not found to be significant. Conclusions: Factors related to the parenting style appear to be important for understanding food refusal behaviors in children. Replication of the findings using longitudinal and observational designs is needed.

Parent strategies for expanding food variety: Reflections of 19,239 adults with symptoms of Avoidant/Restrictive Food Intake Disorder.

To characterize helpful parent feeding strategies using reflections on childhood eating experiences of adults with symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID). We explored a unique text-based dataset gathered from a population of N= 19,239 self-identified adult "picky eaters." The sample included adults with symptoms of ARFID as evidenced by marked interference in psychosocial functioning, weight loss/sustained low weight, and/or nutritional deficiency (likely ARFID), and non-ARFID participants. We leveraged state-of-the-art natural language processing (NLP) methods to classify feeding strategies that were perceived as helpful or not helpful. The best classifiers that distinguished helpful approaches were further analyzed using qualitative coding according to a grounded theory approach. NLP reliably and accurately classified the perceived helpfulness of caregivers' feeding strategies (82%) and provided information about features of helpful parent strategies using recollections of adults with varying degrees of food avoidance. Strategies perceived as forceful were regarded as not helpful. Positive and encouraging strategies were perceived as helpful in improving attitudes toward food and minimizing social discomfort around eating. Although food variety improved, adults still struggled with a degree of avoidance/restriction. Adults perceived that positive parent feeding strategies were helpful even though they continued to experience some degree of food avoidance. Creating a positive emotional context surrounding food and eating with others may help to eliminate psychosocial impairment and increase food approach in those with severe food avoidance. Nevertheless, additional tools to optimize parent strategies and improve individuals' capacity to incorporate avoided foods and cope with challenging eating situations are needed.

Teachers’ and Parents’ Perceptions on Eating Behaviour of Primary School Students: A Qualitative Study

This study explores the perceptions involved in the healthy eating behaviour of 1st, 2nd, and 3rd-grade students in a primary level community school in Nepal. A total, ten observations during mid-day meal and three focus group discussions were conducted among teachers and parents. Sixty students from grade one to three, five teachers and sixteen parents took part in the study. All the participating teachers and parents were engaged in dialogue conferences during focus groups and students’ eating behaviours were observed by the teachers and parents during tiffin time throughout the study. Thematic-content analysis based on the qualitative approach was used on the collected data from the field notes during a series of participant observations and focus group discussions. It is found that the family norms and feeding culture around a child’s domestic life have an active role in establishing and promoting healthy habits that persists throughout. It is also noted that parental food habits and feeding strategies are the most dominant determinants of children eating behaviour and food choices of mid-day meal during tiffin time at the school. It is recommended that parents and teachers should expose their children and students to a range of good food choices and acting as positive role models. 

Associations Between Parent–Child Communication and Connectedness, Parent Feeding Behavior, and Child Body Mass in Pre-Adolescent Children

This study evaluated associations between parent-child connectedness and communication, parent feeding behaviors (restriction, pressure to eat, and monitoring), and age- and sex-standardized child body mass index (zBMI) in a sample of pre-adolescent children aged 8-12 years. A community sample of three hundred and eight child-parent dyads completed measures of communication and connectedness. Parents completed a feeding behavior measure and children were weighed and their height was measured. We examined whether parental feeding behaviors and parent-child communication and connectedness predicted child zBMI and whether parental feeding behaviors moderated the association between parent-child communication and connectedness and child zBMI. Feeding restriction was positively associated with zBMI, while both pressure to eat and food monitoring exhibited negative associations with zBMI. Child-reported communication was inversely associated with zBMI and parental pressure to eat moderated this association such that lower pressure to eat predicted a stronger association between communication and zBMI. These findings are consistent with previous research suggesting that parent feeding strategies and parent-child communication are important contributors to child weight status. This study also provides preliminary evidence suggesting that adaptive parent-child communication is associated with lower body mass when parents avoid pressuring their child to eat. Our study provides an important extension of this body of research into middle childhood, a relatively understudied developmental stage.

Dialogical construction of parental feeding strategies during family mealtimes.

This study focuses on social interactions during family mealtimes to examine the types of arguments used by parents to convince their children to eat. The results of this study show that feeding practices during mealtimes are dialogically constructed by parents and children together. Parents mostly used arguments based on the quality and quantity of food, adapting their language to the child's level of understanding. Future research might consider the observations and the subtle qualitative analyses of social interactions among family members as examples of possible ways to recognize the dialogical construction of feeding practices during mealtimes.

Dialogical Construction of Parental Feeding Strategies During Family Mealtimes

This study focuses on social interactions during family mealtimes to examine the types of arguments used by parents to convince their children to eat. The results of this study show that feeding practices during mealtimes are dialogically constructed by parents and children together. Parents mostly used arguments based on the quality and quantity of food, adapting their language to the child’s level of understanding. Future research might consider the observations and the subtle qualitative analyses of social interactions among family members as examples of possible ways to recognize the dialogical construction of feeding practices during mealtimes.

Factors Influencing Children's Eating Behaviours.

Relevant factors involved in the creation of some children’s food preferences and eating behaviours have been examined in order to highlight the topic and give paediatricians practical instruments to understand the background behind eating behaviour and to manage children’s nutrition for preventive purposes. Electronic databases were searched to locate and appraise relevant studies. We carried out a search to identify papers published in English on factors that influence children’s feeding behaviours. The family system that surrounds a child’s domestic life will have an active role in establishing and promoting behaviours that will persist throughout his or her life. Early-life experiences with various tastes and flavours have a role in promoting healthy eating in future life. The nature of a narrative review makes it difficult to integrate complex interactions when large sets of studies are involved. In the current analysis, parental food habits and feeding strategies are the most dominant determinants of a child’s eating behaviour and food choices. Parents should expose their offspring to a range of good food choices while acting as positive role models. Prevention programmes should be addressed to them, taking into account socioeconomic aspects and education.

“That’s enough now!”: A prospective study of the effects of maternal control on children’s snack intake

The aim of this study was to investigate maternal feeding strategies as prospective predictors of young children’s snack intake. Participants were 252 mothers of children aged 3–11 years old who completed questionnaire measures of parent feeding strategies (Restriction and Covert Control) and reported on their child’s healthy and unhealthy snack intake at two time points separated by three years. Longitudinal regression models showed no prediction of healthy snack food intake. However, Time 1 parental restrictive feeding predicted greater unhealthy snack intake at Time 2, while Time 1 covert feeding strategies predicted lower unhealthy snack intake at Time 2. Structural equation modeling showed that these associations were independent of known covariates that influence children’s snack intake (child and parent weight, education level and SES). The results provide longitudinal evidence for the negative impact of restrictive parent feeding strategies on children’s snack intake and highlight the importance of dissuading parents from using this type of feeding control. Instead, parents should be encouraged to use more covert feeding strategies that are associated with less unhealthy snack intake over the longer term.

‘My Child Doesn’t Eat!’; Parental Feeding Strategies, Parental Attitudes and Family Functioning of Children with Poor Appetite

‘My Child Doesn’t Eat!’; Parental Feeding Strategies, Parental Attitudes and Family Functioning of Children with Poor Appetite

Childhood overweight and obesity amongst primary school children in Hai Phong City, Vietnam.

Childhood obesity is a rising health concern in Vietnam, however, research in this area is not extensive. The aim of this study was to determine the prevalence of childhood overweight and obesity, and to study associations between weight status and selected lifestyle factors, such as diet and physical activity levels, among children aged 6-10 years in Hai Phong City, Vietnam. Two hundred and seventy-six children from an urban and a rural primary school participated in this cross-sectional study. Data on weight, height and waist circumference were used to calculate BMI, and waist-height ratio to determine the proportion of children who were overweight, obese and had high central adiposity. Information on diet, physical activity and socioeconomic status of families was collected using questionnaires. Prevalences of overweight, obesity and high abdominal adiposity were 11.2%, 10.1% and 19.9%, respectively. Children who completed >=60 minutes of physical activity daily were 50% and 80% less likely to be overweight and have high abdominal adiposity, respectively. Computer usage increased the odds of overweight and high abdominal adiposity by 4.5 and 3.9 times, respectively. Mothers with higher education and income levels increased the risk of their children being overweight (p<0.05). Physical inactivity and high maternal education and income levels increased the risk of childhood overweight and obesity in this cohort. Future interventions should target parents and their children by providing both with educational modules centred on healthy eating habits, parental feeding practices and strategies for increasing physical activity.

Offspring Hg exposure relates to parental feeding strategies in a generalist bird with strong individual foraging specialization

Generalist species can potentially exploit a wide variety of resources, but at the individual level they often show a certain degree of foraging specialization. Specific foraging strategies, however, may increase exposure to environmental contaminants that can alter the cost-benefit balance of consuming particular food items. The Lesser Black-backed Gull (Larus fuscus) is known to opportunistically feed on a wide range of marine and terrestrial prey that differ in contaminant load, such as mercury (Hg) that strongly biomagnifies through the aquatic food web. The hypothesis tested in this study were: i) a predominant use of marine prey by females during egg-formation and by both parents during chick rearing increases the exposure to Hg during embryonic development and chick growth, and ii) this affects parental investment in clutch volume, chick growth and body condition. Total Hg burden and isotopic signatures of carbon (δ13C) and nitrogen (δ15N) were determined for eggs, down feathers, and primary feathers of L. fuscus chicks collected at a coastal colony in Belgium. As expected, eggs and feathers of chicks from parents with a stable isotope signature that suggested a predominantly marine diet had higher levels of Hg. The use of marine resources by females during the egg-formation period positively correlated to maternal investment in egg size, though entailing the cost of increased Hg-concentrations which in turn negatively affected clutch volume. Furthermore, it is shown that the use of chick down feathers is a suitable matrix to non-lethally estimate Hg concentrations in eggs. Contrary to our expectations, no relationship between Hg exposure and chick growth or chick body condition was found, which may be due the low concentrations found. We conclude that currently Hg contamination does not constitute a risk for development and condition of L. fuscus offspring at the levels currently observed at the Belgian coast.

Three broad parental feeding styles and young children’s snack intake

Objective: The aim of this study was to identify broad overarching feeding styles that parents may use and their effects on pre-school-aged children’s healthy and unhealthy snack intake. Design: Cross sectional study Methods: Mothers ( n = 611) of children aged 2–7 years (mean age 3.9 years) completed an online survey assessing parent-feeding strategies and parent-reported child snack intake. Data were analysed in two phases. First, principal components analysis identified three major feeding styles that were labelled overt control, covert control and parent modelling. Then, structural equation modelling was used to see whether these factors were related differentially to reported child snack intake. Results: The intake of healthy snack food was associated with higher covert control and parent modelling and lower overt control. The reverse was true for unhealthy snack intake, with the intake of these foods associated with lower covert control and parental modelling, and higher overt control. Conclusion: Our findings show that parent-feeding styles that attempt to control the child’s environment seem to have a positive impact on snack intake, while styles aimed at controlling the child (overt control) seem to have a detrimental impact.

Associations between Parenting Style and Parent and Toddler Mealtime Behaviors

BackgroundBy the time a child is 24 mo old, 50% of parents report experiencing picky eating behaviors with their child. These behaviors include consuming an inadequate dietary variety, eating the same foods repeatedly, and an unwillingness to try either new or familiar foods. Previous research has established relations with regard to the impact of parent feeding strategies on child mealtime behaviors and how parent feeding strategies are influenced by parenting style; however, to our knowledge, no studies have investigated whether there is an association between parenting style and perceived child mealtime behaviors specifically related to picky eating. ObjectiveThe purpose of this study was to investigate whether a relation exists between general parenting style and both parent feeding strategies and perceived picky eater and non–picky eater (NPE) behaviors. MethodsParents of 2- to 5-y-old children (n = 525) completed 2 online surveys: 1) the Mealtime Assessment Survey, which measures the frequency of parent and child mealtime behaviors, and 2) the Parenting Styles and Dimensions Questionnaire, which measures authoritative, authoritarian, and permissive parenting styles. Spearman’s correlation analysis was conducted to determine the relations between parenting style and mealtime behavior. ResultsPositive correlations were found between an authoritative parenting style and NPE behaviors, as well as parent mealtime strategies that promote positive eating habits. Authoritarian and permissive parenting styles were positively correlated with child behaviors associated with picky eating and parent mealtime strategies that can negatively influence child feeding. ConclusionsThese findings suggest that a relation exists between general parenting style and both parent and child mealtime behaviors; however, the directionality of the relation remains unknown. The positive correlations seen within the authoritative parenting style with regard to NPE behaviors suggest the use of authoritative feeding methods to overcome feeding difficulties.

Structure-based feeding strategies: A key component of child nutrition

ObjectiveThis study examined the relationship between structure, autonomy promotion, and control feeding strategies and parent-reported child diet. ParticipantsParticipants (N = 497) were parents of children ages 2.5 to 7.5 recruited from Amazon Mechanical Turk. This sample was a Caucasian (79%), educated sample (61% college graduates) with most reports from mothers (76%). Methods and measuresOnline survey including measures of parent feeding strategies and child dietary intake. ResultsUse of structure-based feeding strategies explained 21% of the variance in child consumption of added sugar, 12% of the variance in child intake of added sugar from sugar-sweetened beverages, and 16% of the variance in child consumption of fruits and vegetables. Higher unhealthy food availability and permissive feeding uniquely predicted higher child added sugar intake and child consumption of added sugar from sugar-sweetened beverages. Greater healthy food availability uniquely predicted higher child fruit and vegetable intake. Conclusionsand Future Directions: In Caucasian educated families, structure-based feeding strategies appear to be a relatively stronger correlate of parent-reported child intake of added sugar and fruits and vegetables as compared to autonomy promotion and control feeding strategies. Longitudinal research may be needed in order to reveal the relationships between autonomy promotion and control feeding strategies with child diet. If future studies have similar findings to this study's results, researchers may want to focus more heavily on investigating the impact of teaching parents stimulus-control techniques and feeding-related assertiveness skills on child dietary intake.

Bi-directional associations between child fussy eating and parents' pressure to eat: Who influences whom?

BackgroundFussy eating is common in young children, often raising concerns among parents. The use of pressuring feeding practices may provoke or worsen child fussiness, but these practices could equally be a parent's response to child fussy eating. ObjectiveIn longitudinal analyses, we assessed directionality in the relation between fussy eating and parent's pressure to eat across childhood. MethodsStudy participants were 4845 mother-child dyads from the population-based Generation R cohort in the Netherlands. The Child Behavior Checklist was used to assess fussy eating (2 items) at child ages 1½, 3 and 6years. Parents' pressure to eat was assessed with the Child Feeding Questionnaire (4 items) when children were 4years old. All scale scores were standardized. ResultsLinear regression analyses indicated that preschoolers' fussy eating prospectively predicted higher levels of parents' pressure to eat at child age 4years, independently of confounders (adjusted B=0.24, 95% CI: 0.21, 0.27). Pressure to eat at 4years also predicted more fussiness in children at age 6years, independently of confounders and of fussy eating at baseline (adjusted B=0.14, 95% CI: 0.11, 0.17). Path analyses indicated that the relation from fussy eating at 3years to parenting one year later was stronger than from pressure at 4years to fussy eating two years later (p<0.001). ConclusionsOur findings suggest bi-directional associations with parental pressuring feeding strategies being developed in response to children's food avoidant behaviors, but also seemingly having a counterproductive effect on fussiness. Thus, the use of pressure to eat should be reconsidered, while providing parents alternative techniques to deal with their child's fussy eating.

Strategies Low-Income Parents Use to Overcome Their Children's Food Refusal.

Introduction Parents play a key role in the development of eating habits in preschool children, as they are the food "gatekeepers." Repeated exposure to new foods can improve child food preferences and consumption. The objective of this study was to determine parent feeding strategies used to influence child acceptance of previously rejected foods (PRF). Methods We conducted eighteen focus groups (total participants=111) with low-income African American and Hispanic parents of preschool children (3- to 5-year-olds) in Texas, Colorado, and Washington. Through thematic analysis, we coded transcripts and analyzed coded quotes to develop dominant emergent themes related to strategies used to overcome children's food refusal. Results We found three major themes in the data: parents most often do not serve PRF; parents value their child eating over liking a food; and parents rarely use the same feeding strategy more than once for a PRF. Desiring to reduce waste and save time, parents said they most often intentionally decided not to purchase or serve PRF to their children. Discussion Because parents' primary goal in child feeding is getting children to eat (over acceptance of a variety of foods), strategies to help parents promote consumption of less easily accepted foods could help parents with child feeding struggles and improve children's dietary quality.

Picky eating: Associations with child eating characteristics and food intake

Food rejection behaviors such as picky eating are of concern for many parents and attempts to increase healthy food intake can cause distress at mealtimes. An important limitation in most of the picky eating studies is that they cover few characteristics of picky eating behaviors and use limited measures of food intake. The objective of this study was to explore the associations between picky eating, child eating characteristics, and food intake among toddlers 12–47.9 months old (n = 2371) using data from the 2008 Feeding Infants and Toddlers Study (FITS). Logistic regression was used to examine associations between demographic and feeding characteristics and picky eater status. Differences in food group intake between picky and non-picky eaters were analyzed. Picky eaters were more likely to be neophobic, texture resistant, and to eat only favorite foods, In addition, the parents of picky eaters tend to offer new food a greater number of times than those of non-picky eaters before deciding that the child does not like it. Picky eaters showed significant lower intakes of eggs, burritos/tacos/enchiladas/nachos and sandwiches than non-picky eaters. Picky eaters consumed fewer vegetables from the “other vegetables” category and less raw vegetables than non-picky eaters. Neophobia, eating only favorite foods and difficulties with texture are all important characteristics of picky eaters which need to be integrated in studies measuring picky eating behaviors. Food intake of picky eaters differs only slightly from non-picky eaters. Because picky eating is a major parental concern, feeding strategies and advice related to the relevant characteristics of picky eating behavior need to be developed and assessed for their effectiveness.

Using food to soothe: Maternal attachment anxiety is associated with child emotional eating

Attachment anxiety (fear of abandonment) is associated with disinhibited eating in adults. Both maternal disinhibited eating and use of emotional feedings strategies are associated with emotional eating in children. On this basis, the current study sought to determine whether attachment anxiety is an underlying maternal characteristic that predicts parental reports of child emotional over-eating via its effects on maternal disinhibited eating and emotional feeding. Mothers of a preadolescent child (N = 116) completed an internet-delivered questionnaire. Maternal attachment anxiety and dietary disinhibition were assessed by the Experiences in Close Relationships questionnaire and the Three Factor Eating Questionnaire, respectively. The Parental Feeding Strategies Questionnaire and the Child Eating Behaviour Questionnaire were used to quantify emotional feeding and child emotional over-eating, respectively. Bias-corrected bootstrapping indicated a significant direct effect of maternal attachment anxiety on child emotional over-eating (i.e., controlling for maternal disinhibited eating and emotional feeding). There was also a significant indirect effect of maternal attachment anxiety on child emotional over-eating via emotional feeding strategies. In a subsequent model to investigate bi-directional relationships, the direct effect of maternal attachment anxiety on emotional feeding strategies was not statistically significant after controlling for child emotional over-eating. There was, however, a significant indirect effect of maternal attachment anxiety on emotional feeding strategies via child emotional over-eating. These findings highlight the influence of maternal attachment anxiety on parental reports of aberrant eating behaviour in children. While this may be partly due to use of emotional feeding strategies, there is stronger evidence for a “child-responsive” model whereby anxiously-attached mothers use these feeding practices in response to perceived emotional over-eating in the child.

Parental feeding practices in Turkish children with autism spectrum disorder: Factorial validation of the Feeding Strategies Questionnaire

ABSTRACTThe Feeding Strategies Questionnaire (FSQ) has not previously been validated either in a Turkish sample or on children with autism spectrum disorder (ASD). In the present study, the factorial validity and reliability of the Turkish version of the FSQ were examined in order to use the assessment of the parental feeding practices on children with ASD. Further, the parental feeding strategies and their possible associations with various child demographic variables (i.e., children’s age groups, gender, severity, comorbidity, and body mass index [BMI]) were investigated. The present study suggests that the FSQ shows a good internal consistency, adequate split-half reliability, and acceptable factorial validity, which confirms that the FSQ can be used to assess the feeding strategies of parents and their children with ASD in a Turkish sample. The FSQ and factors scores were calculated as a moderate level. There were no significant differences in regard to FSQ by age group, gender, severity of disability, or comorbidity. BMI scores indicate the risk of overweight for a sample of Turkish children with ASD. There was a just significant and negative correlation between the coercive interactions factor of FSQ and BMI average score, which may be interpreted that when BMI score reduces, parents tend to be in coercive feeding style.

Managing young children's snack food intake. The role of parenting style and feeding strategies

One major contributor to the problem of childhood overweight and obesity is the over-consumption of foods high in fat, salt and sugar, such as snack foods. The current study aimed to examine young children's snack intake and the influence of feeding strategies used by parents in the context of general parenting style. Participants were 611 mothers of children aged 2–7 years who completed an online questionnaire containing measures of general parenting domains and two particular feeding strategies, restriction and covert control. It was found that greater unhealthy snack intake was associated with higher restriction and lower covert control, while greater healthy snack intake was associated with lower restriction and higher covert control. Further, the feeding strategies mediated the association between parental demandingness and responsiveness and child snack intake. These findings provide evidence for the differential impact of controlling and positive parental feeding strategies on young children's snack intake in the context of general parenting.