Child weight status and accuracy of perceived child weight status as predictors of Latina mothers' feeding practices and styles

Authors: HIDALGO-MENDEZ, JACKELYN - WASHINGTON STATE UNIVERSITY; POWER, THOMAS - WASHINGTON STATE UNIVERSITY; FISHER, JENNIFER - TEMPLE UNIVERSITY; O'CONNOR, TERESIA - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); HUGHES, SHERYL - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)

Submitted to: Appetite
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/28/2019
Publication Date: 7/29/2019
Citation: Hidalgo-Mendez, J., Power, T.G., Fisher, J.O., O'Connor, T.M., Hughes, S.O. 2019. Child weight status and accuracy of perceived child weight status as predictors of Latina mothers' feeding practices and styles. Appetite. 142:104387. https://doi.org/10.1016/j.appet.2019.104387.
DOI: https://doi.org/10.1016/j.appet.2019.104387

Interpretive Summary: Parental feeding clearly influences when, where, and how much children eat. Parental feeding directives may be influenced by perceptions of their child's weight. Research shows that parents tend to underestimate the weight status of their young children. This is particularly true for low-income, Latina mothers. However, there is a dearth of studies to support the relationship between parents' accuracy in estimating their child's weight status and parental feeding styles and practices. To address this gap, we examined the relationship between low-income, Latina mothers’ accuracy in estimating their preschool child's weight status and maternal feeding. We also examined the independent effect of actual child weight status and maternal concern about child weight on this relationship. A total of 186 dyads of low-income Latina mothers and their preschool child participated in the study. The majority of mothers underestimated the weight status of their child, but this varied by child weight – 30% of mothers of healthy weight children underestimated their child's weight compared to 97% of mothers of overweight or obese children. Furthermore, we found that actual weight of the child was the strongest predictor of maternal feeding practices and feeding styles. Mothers of children with higher BMI reported higher levels of healthy eating guidance and responsiveness during feeding and lower levels of pressure to eat, using food as reward, and using food to regulate the child's emotions. These mothers were more likely to show an indulgent feeding style (high responsiveness and low demandingness). Maternal perceptions only mattered when restricting food for weight purposes where there were independent effects of both perceived and actual child weight status. Given the high level of underestimation of child weight in this sample, results suggest that mothers in this population may need some guidance in helping them to identify a healthy weight for their children. Although underestimation was not a strong predictor of maternal feeding practices, mothers of obese children who perceived their child as overweight reported more concern about their child's weight and engaged in more restriction for weight-related purposes compared to mothers who saw their obese child as having an average weight. If these mothers of overweight and obese children would have been aware of a normal weight status as their children were becoming overweight or obese, as well as addressing weight concerns by using other directives beyond restriction, childhood obesity may have been averted.

Technical Abstract: This study focused on the relationship between low-income Latina mothers' perceptions of their preschool children's weight status and maternal feeding practices and styles, also considering the effects of actual child weight status and maternal concern about child weight. A total of 186 low-income Latina mother-child dyads participated. The vast majority of mothers underestimated the weight status of their child, but this varied by child weight status. Although only 30% of mothers of healthy weight children underestimated their child's weight status, 97% of mothers of overweight or obese children did so. No mother overestimated her child's weight status. Contrary to our hypotheses, in most cases, maternal perceptions of child's body weight were not related to maternal feeding styles, nor were many feeding practices predicted by concern about child weight. Instead, children's actual weight status was the strongest predictor of maternal feeding practices and feeding styles. Mothers of children with higher BMI z-scores reported higher levels of healthy eating guidance and responsiveness during feeding and lower levels of pressure to eat, food as reward, and using food to regulate the child's emotions. These mothers were more likely to show an indulgent and less likely to show an authoritarian feeding style. Concern about child weight did not account for any of these significant correlations. Maternal perceptions only mattered for restriction for weight purposes where there were independent effects of both perceived and actual weight status. Implications for understanding the development of child obesity in low-income, Latino populations are considered, along with recommendations for future research and for childhood obesity prevention programs.