Parental Feeding Styles and Their Association With Complementary Feeding Practices and Growth in Mexican Children

Background: Complementary feeding practices and corresponding parental feeding styles influence nutritional status in later stages of childhood. Findings on the association of these variables with infant growth remain inconsistent; in Mexico, a research gap exists in this area.Research Aims: (1) To characterize parental feeding styles and complementary feeding practices, and (2) to evaluate the association of parental feeding styles with complementary feeding practices and infant growth at 6 and 9 months of age.Methods: Data were collected from a prospective Mexican birth cohort. Parental feeding styles, complementary feeding practices, and anthropometric data from 263 to 234 mother-child pairs (infants of 6 and 9 months of age, respectively) were analyzed. Logistic and linear regression models were used to determine the associations between variables.Results: The predominant parental feeding style was the “responsive style” (90%). Only 43.7 and 8.1% of 6- and 9-month-old infants, had adequate complementary feeding practices, respectively. At 6 months, mothers who were responsive to satiety signals had 11% lesser possibilities (OR = 0.89, 95% CI [0.80, 0.98]) of their infant having inadequate complementary feeding practices than their counterparts and “pressuring to finish” and “pressuring to eat cereal” sub-constructs were associated with lower weight for length and body mass index Z-scores (p = 0.02).Conclusions: A high proportion of infants (>40%) did not meet international recommendations. The “pressuring” parental feeding style sub-constructs were associated with growth indicators in 6-month old infants. This emphasizes the importance of promoting parental responsiveness to infant appetite and satiety signals to achieving adequate complementary feeding practices.

Cross-cultural adaptation and validation of the Infant Feeding Style Questionnaire in Brazil

We cross-culturally adapted and validated the Infant Feeding Style Questionnaire (IFSQ) in Brazil. The cross-cultural adaptation and content validity assessment was conducted in five steps: translation, synthesis of translations, back-translation, evaluation by experts, and pre-test. To evaluate reliability, construct validity, and floor and ceiling effects, interviews were conducted with 465 mother-infant pairs at Primary Health Centers in the Federal District, Brazil. The mothers answered the Brazilian Portuguese version of the IFSQ (IFSQ-Br), which evaluated four feeding styles (laissez-faire, pressuring, restrictive, and responsive) from 9 sub-constructs. The indulgent style was not evaluated due to time limitation. We performed reliability analysis using Cronbach’s alpha coefficient and construct validity was evaluated through Confirmatory Factor Analysis. Higher means were found in the sub-constructs of the responsive and restrictive styles. The IFSQ-Br presented adequate reliability (α = 0.73) with values for the Cronbach’s alpha coefficient of the sub-constructs ranging from 0.42 to 0.75. In the Confirmatory Factor Analysis, the final models presented good fit, with the Comparative Fit Indices (CFI) ranging from 0.86 to 1.0 and the Root-Mean Squared Error of Approximation (RMSEA) between 0.0 and 0.09. The IFSQ-Br was shown to be a valid and reliable questionnaire to evaluate maternal feeding beliefs and behaviors in Brazil. Future studies should evaluate the psychometric properties of the indulgent style and include mother-infant pairs from different cultural contexts in Brazil.

A new protocetid whale offers clues to biogeography and feeding ecology in early cetacean evolution

Over about 10 million years, the ancestors of whales transformed from herbivorous, deer-like, terrestrial mammals into carnivorous and fully aquatic cetaceans. Protocetids are Eocene whales that represent a unique semiaquatic stage in that dramatic evolutionary transformation. Here, we report on a new medium-sized protocetid, Phiomicetus anubis gen. et sp. nov., consisting of a partial skeleton from the middle Eocene (Lutetian) of the Fayum Depression in Egypt. The new species differs from other protocetids in having large, elongated temporal fossae, anteriorly placed pterygoids, elongated parietals, an unfused mandibular symphysis that terminates at the level of P 3 , and a relatively enlarged I 3 . Unique features of the skull and mandible suggest a capacity for more efficient oral mechanical processing than the typical protocetid condition, thereby allowing for a strong raptorial feeding style. Phylogenetic analysis nests Phiomicetus within the paraphyletic Protocetidae, as the most basal protocetid known from Africa. Recovery of Phiomicetus from the same bed that yielded the remingtonocetid Rayanistes afer provides the first clear evidence for the co-occurrence of the basal cetacean families Remingtonocetidae and Protocetidae in Africa. The discovery of Phiomicetus further augments our understanding of the biogeography and feeding ecology of early whales.

Mindful Parenting, Maternal Child Feeding Style and Prescholer's Body Mass Index

Objectives To compare the dimensions and total score of Mindful Parenting (MP) according to the Maternal Child-Feeding Style (MCFS), 2) To identify the MCFS with the highest BMI average score and to verify if there are significant differences. Methods This study was of the descriptive and correlational type. The sample was determined for a multiple linear regression model with eight variables, significance of 0.5, test power of 90%, and effect size of .07. Participated, 334 dyads (mothers and her preschool child). The child attended 10 publish kindergartens in Monterrey, Nuevo Leon, México. Mothers answered the Interpersonal Mindfulness in Parenting Scale and the Caregiver's Feeding Styles Questionnaire. The preschooler's weight and height were measured. Descriptive and inferential statistics were applied. Results The MP dimension with the highest average was Emotional Awareness of the Self and the Child (Mean = 71.14, SD = 14.90), the average of the total score of MP was 69.48 (SD = 10.60). The indulgent MCFS was the most frequent 33.7% (n = 116). The authoritative MCFS presented the highest score of MP (H = 27.068, P = .001). The indulgent MCFS presented the highest average range of child's BMI (121.70) when compared against the authoritarian MCFS (102.62), a significant difference was identified (U = 5197.00, P < .05). Conclusions The authoritative MCFS had highest score of MP. Moreover the authoritative MCFS had been related to health child's BMI. It is recommended to design interventions to promote MP and authoritative MCFS. Funding Sources …

Effects of Healthy Change Intervention on Childhood Obesity Prevention in Mexico

Objectives To evaluate the effects of the Healthy Change intervention on maternal perceptions of their child's body weight (MPCW), weight status as overweight-obese (OW-OB), and associated variables (child’ BMI, maternal feeding style, and obesogenic home environment) in Mexico. Methods Randomized control trial consisted of two arms: the intervention group received Healthy Change, and control group received Hygiene and Accident Prevention. Data were collected at baseline and at the end of the program via self-administered questionnaires by mothers and anthropometric measurement in children. Results The proportion of mothers who accurately identified their children's weight status increased at study endpoint in both groups. The intervention group also showed a shift of mothers feeding style towards an authoritative style (17.4 vs 26.2, P < 0.001) and favorable changes family nutrition and physical activity environment scores on family eating practices, healthy home environment, family and child's physical activity. Conclusions The Healthy Change Intervention contributed to an increased recognition of children's overweight status, a shift toward a maternal authoritative feeding style, and favorable changes in family nutrition and physical activity environment. Funding Sources The National Council for Science and Technology (CONACYT)

Parenting Stress, Maternal Feeding Styles and Preschooler's Body Mass Index

Objectives To analyze the relationship between parenting stress and maternal child feeding styles with preschooler's body mass index. Methods A total of 344 mother-child dyads from ten public kindergartens from Monterrey Nuevo Leon, Mexico; participated in the study. Mothers answered 1) The Parental Stress Scale to identified parenting stress, and) The Caregiver Feeding Style Questionnaire was used to identify the mother's feeding style. Child's weight and height were measured. Body Mass Index was obtained and classify according to World Health Organization. Results 51.7 (n = 178) mothers reported high parenting stress. The authoritarian feeding style was more frequent in mothers with high parenting stress 33.1 (n = 59), while mothers with low parenting stress presented an indulgent feeding style (38.6%, n = 64). Mothers with an indulgent style had children with a high BMI. Maternal factors such as styles and preschool BMI were identified as predictors of parenting stress, variance explained 7.3%. Conclusions High maternal parenting stress is related to authoritarian feeding style. A style has been considered a predictor of childhood overweight-obesity. It is recommended to continue studying those maternal factors that potentiate the risk of overweight-obesity in childhood, as well as interventions aimed at reducing parenting stress and the use of healthier feeding styles. Funding Sources ….

Maternal Feeding Styles of Young Infants: Associations With Race and Feeding Mode

Objectives Feeding styles, defined as parental attitudes and practices related to feeding, have been examined in early childhood in relation to risk of developing overweight/obesity. However, less is known about feeding styles in the first few months of life. The current study examined whether early feeding styles differ by feeding mode and race in a community sample of mothers/infant dyads participating in the Infant Growth and Development Study (iGrow). Methods Data was collected from 148 mother/infant dyads participating in iGROW. Maternal characteristics were assessed during the third trimester of pregnancy and feeding styles and feeding mode were assessed when infants were between 2–4 months. Scores across 5 feeding styles were estimated using the Infant Feeding Style Questionnaire (IFSQ): pressuring/controlling, restrictive, indulgent, responsive, and laissez-faire. Differences in feeding style by race and feeding mode were examined using analysis of variance, controlling for socioeconomic and demographic variables. Results Mothers identified as non-Hispanic white (n = 73), black (n = 50), or multiracial/other (n = 25) and 46.6% reported exclusive breastfeeding. After controlling for covariates (maternal demographic and socioeconomic factors), indulgent feeding was significantly higher among black mothers compared to other mothers (F (1,126) = 2.98, p = .05, partial n2 = 1.44). Significant differences in restrictive feeding scores were identified by feeding mode (F (1,126) = 6.22, p = .01, partial n2 = 2.21), with exclusively breastfeeding mothers scoring lower than mothers who used formula/mixed feeding. Conclusions Differences in feeding styles are apparent in the first months of life. Future research is needed to understand factors that contribute to the development of early feeding styles. Funding Sources Eunice Kennedy Shriver National Institute of Child Health & Human Development.

Consumption of ultra-processed foods in adolescents with obesity and its association with food educational style of their parent: observational study (Preprint)

BACKGROUND Eating habits and the parental educational model are both contributors to the development of childhood obesity. OBJECTIVE We aimed to assess the consumption of ultra-processed foods (UPF) in adolescents with obesity and to determine the association with the food educational style of their parent. METHODS This observational study included 24 participants: 12 adolescents aged from 12 to 14 years and their 12 parents who were followed in a specialized pediatric obesity clinic. Adolescents were asked to take a photograph with a smartphone application of all meals and beverages consumed in their daily routine over 14 consecutive days. They evaluated their parent’s food educational style using the Kids’ Child Feeding Questionnaire. The parent who was present at the study visits also completed the Feeding Style Questionnaire. A dietitian analyzed the pictures to extract food group portions and to identify UPF using the NOVA classification. A non-parametric statistical test was used to investigate associations between UPF intake and food educational style. RESULTS Overall, the adolescents (eight boys and four girls) had unbalanced dietary habits compared to national recommendations. They consumed an insufficient quantity of vegetables, fruits, dairy products, and starchy foods and an excessive amount of meat portions, and sugary and fatty products compared to the current Swiss recommendations. Their consumption of UPF accounted for 20% of their food intake. All teenagers defined their parent as being restrictive in terms of diet, with a mean parental restriction score of 3.3 ± standard deviation 0.4 (norm median = 2.1). No parent reported a permissive educational feeding style. A higher intake of UPF was associated with lower parental restriction scores (p = 0.04). CONCLUSIONS Despite being followed in a specialized pediatric obesity clinic, these adolescents had an unbalanced diet, which included 20% UPF. The intake of UPF was lower in participants whose parent was more restrictive, suggesting the importance of parents as role models and to provide adequate food at home. CLINICALTRIAL ClinicalTrials.org registry no. NCT03241121

Maternal feeding style and child weight status among Hispanic families with low-income levels: a longitudinal study of the direction of effects

Background The home environment is a central and modifiable influence on the development of childhood obesity. Evidence supports the central role of parents in shaping problematic child eating behaviors and excess weight. Most studies of feeding emphasize parent-driven influences without taking into account the child’s role in eating interactions. Few studies have addressed the bi-directional nature of feeding dynamics in studies of young children. Methods The goals of this study were: 1) to examine if parental feeding styles during preschool (4–5 years) predict child weight status at 7–9 years, and 2) to examine the direction of effects between parental feeding styles and child weight status over time. Participants were part of a larger longitudinal study of Hispanic Head Start families living in the West South Central United States. Data from mother/child dyads were collected at three time points: Time 1 (ages 4–5), Time 2 (ages 5 ½-6 ½), and at Time 3 (ages 7–9). Only data from the Times 1 and 3 were used in the current analyses. A total of 128 mothers and their children had data on all variables needed for the analyses. Assessments included parent-reported feeding styles, feeding practices, acculturation, child eating behaviors, and child height and weight. Hierarchical regression was used to examine the first aim; a cross-lagged panel analysis examined the second aim. Results An indulgent parental feeding style at ages 4–5 was associated with increased child BMI z-score at ages 7–9. Indulgent feeding significantly contributed to child BMI z-score beyond demographics, baseline child BMI z-score, parental acculturation, and child eating behaviors. Regarding the direction of effects in parental feeding interactions, the cross-lagged analyses showed that both indulgent feeding style and authoritative feeding style at Time 1 positively predicted child BMI z-scores at Time 3. Child effects were significant as well. Child BMI z-score at Time 1 positively predicted indulgent feeding and negatively predicted authoritarian feeding at Time 3. Conclusions Indulgent feeding should be addressed in future family-focused childhood obesity initiatives focused on young children and their parents.