Observations of maternal feeding practices and styles and young children's obesity risk: A longitudinal study of Hispanic mothers with low incomes

Authors: POWER, THOMAS - Washington State University; BECK, ASHLEY - Washington State University; FISHER, JENNIFER - Temple University; MICHELI, NILDA - Children'S Nutrition Research Center (CNRC); O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC); HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC)

Submitted to: Childhood Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/1/2020
Publication Date: 1/1/2021
Citation: Power, T.G., Beck, A.D., Fisher, J.O., Micheli, N., O'Connor, T.M., Hughes, S.O. 2021. Observations of maternal feeding practices and styles and young children's obesity risk: A longitudinal study of Hispanic mothers with low incomes. Childhood Obesity. 17(1):16-25. https://doi.org/10.1089/chi.2020.0178.
DOI: https://doi.org/10.1089/chi.2020.0178

Interpretive Summary: Research has established that the feeding practices and styles used by parents are related to children’s weight status. However, most studies have been cross-sectional, which only allows for the assessment of parental feeding and child weight at the same time point. Moreover, most studies have used parental self-report of feeding behaviors, which have shown either nonsignificant or small associations with direct observations of these behaviors. To address these limitations, the current study examined the relationship between observed and self-reported parental feeding practices and styles and children's weight in a sample of Hispanic mothers with low incomes and their preschool children over a period or 3.5 years. Specifically, at the first time point, 187 parents and their 4 to 5 year old child were observed during a buffet meal in a laboratory setting and coded for feeding styles and practices; parents also self-reported on their styles and practices. Additionally, children’s standardized body mass index (BMIz) was assessed at the first time point and 3.5 years later. Overall, findings from this study show that mothers who pressured their child to eat had children who are at greater risk for the development of later obesity. In contrast, maternal reasoning and monitoring appear to be protective against later development of child obesity. This study is the first to show how a multiple-method approach of assessing feeding can help demonstrate the important role of parental feeding in the development of obesity in young children. The results have implications for the development of childhood obesity prevention programs. Specifically, caregivers should be encouraged to avoid frequent prompts to eat during mealtimes, and not engage in an indulgent type feeding. By providing children with the structure and guidance, in a way that is responsive to the child's behavior and needs, parents can help young children develop healthy eating habits and reduce the risk of childhood obesity.

Technical Abstract: Maternal feeding practices and styles are well-established correlates of children's BMI z-scores in the preschool years. Most studies, however, are cross-sectional, using maternal self-reports to examine feeding. This study examined, over a 3.5-year period, the relationship between observed and self-reported feeding practices/styles and children's BMI z-scores in a sample of Hispanic mothers with low incomes and their preschool children. One hundred eighty-seven mothers were observed feeding their 4- to 5-year old during a buffet meal in a laboratory setting and completed self-report measures on their feeding practices and styles. Children's BMI z-scores were assessed at this visit and 3.5 years later. Consistent with previous research, observed and self-reported pressure to eat and/or authoritarian feeding were negatively associated with children's BMI z-scores at the first time point; observed discouraging eating was positively associated. However, children's BMI z-scores 3.5 years later, controlling for Time 1 BMI z-scores, were positively associated with observed pressure to eat. Observed maternal reasoning and self-reported monitoring of children's eating behavior at Time 1 were negatively associated with later BMI z-scores. Only self-reported feeding styles predicted later children's BMI z-scores, with indulgent and authoritative styles positively associated with children's BMI z-scores at the third time point. These findings demonstrate that mothers who ignore their children's fullness cues and pressure them to eat have children who are at greater risk for the development of later obesity. Implications for the development of family-focused childhood obesity prevention programs are discussed.