Coparenting in the feeding context: perspectives of fathers and mothers of preschoolers

Applying the Family Stress Model to responsive feeding and early obesity prevention

Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.

Children's eating behavior and weight-related outcomes: A latent profile analysis of parenting style and coparenting

Parenting style is associated with children's eating behavior, yet less is known about how parenting style and coparenting are both related to children's eating behavior (food approach behavior and palatable food intake) and weight-related outcomes (concern about child weight and perceived child weight). The aims of the current research were 1) to determine family profiles based on parenting style and coparenting, 2) to examine whether the family profiles were associated with parent (sex, BMI, age) and child (sex, age) characteristics, and 3) to examine whether the family profiles differed in children's outcomes. Parents (n = 185; Mage = 36.38 years, SD = 7.69) of 3- to 8-year-old children completed an online survey. Latent profile analysis revealed three family profiles: 1) Responsive and Cooperative, 2) Minimally Structured, and 3) Demanding and Competitive. The family profiles were not related to any parent or child characteristics. The Responsive and Cooperative family profile was associated with the lowest food approach behavior, palatable food intake, and weight-related outcomes, followed by the Minimally Structured family profile, and finally the Demanding and Competitive family profile with the highest scores. These findings suggest family dynamics play an important role in children's propensity to engage in food approach behavior and palatable food intake.

Coparenting: Associations with parents' psychological distress and children's food approach behavior

Parents' psychological distress has been associated with their children's obesogenic eating yet less is known about how coparenting moderates this relationship. The aim of the current research was 1) to examine how coparenting (general and feeding) moderates the associations between parents' psychological distress and children's food approach behavior after accounting for parents' coercive control food parenting and 2) to examine whether feeding coparenting interacted with psychological distress to predict children's food approach behavior above and beyond general coparenting. Parents (n = 216; Mage = 36.28 years, SD = 6.12) of 3- to 5- year old children completed an online survey. Analyses revealed that undermining coparenting and feeding coparenting (but not supportive coparenting) moderated the association between parents' psychological distress and children's food approach behavior. Additionally, analyses revealed that feeding coparenting interacted with psychological distress to predict children's food approach behavior above and beyond general coparenting. These findings suggest that less optimal coparenting relationships, particularly feeding coparenting, may exacerbate the influence of parents' psychological distress on obesogenic eating behaviors in children.

Associations of mothers' and fathers' structure-related food parenting practices and child food approach eating behaviors during the COVID pandemic

BACKGROUND

During the COVID-19 pandemic, many mothers and fathers have spent more time at home with their children, warranting consideration of parenting practices around food during the pandemic as influences on obesogenic eating behaviors among children. Structure-related feeding practices, particularly around snacking, may be particularly challenging yet influential in the pandemic setting. Parent sex and levels of feeding-related co-operation among parents (co-feeding) are understudied potential influences on parent-child feeding relationships.

METHODS

We investigated relationships between structure-related parent feeding and child food approach behaviors during the COVID-19 pandemic, while considering potential moderating influences of parent sex and co-feeding levels. An online survey was completed by 318 parents (206 mothers and 112 fathers) of 2-12-year-olds who were living in states with statewide or regional lockdowns in May/June 2020 within the US. Mothers and fathers were drawn from different families, with each survey corresponding to a unique parent-child dyad. Parental stress/mental health, co-feeding (Feeding Coparenting Scale), structure-related food and snack parenting (Feeding Practices and Structure Questionnaire and Parenting around SNAcking Questionnaire), and child eating behaviors (Child Eating Behaviour Questionnaire) were assessed. Relationships of parents' structure-related food and snack parenting practices with their child's emotional overeating and food responsiveness behaviors were examined using structural equation modelling. Further, we investigated whether these relations were moderated by parent sex or level of co-feeding.

RESULTS

Parent sex differences were seen in parental stress, mental health, and co-feeding, but not in structure-related food and snack parenting or child food approach eating behaviors. Structure-related food parenting was negatively associated with emotional overeating. However, structure-related snack parenting was positively associated with emotional overeating and food responsiveness. While regression paths varied between mothers vs. fathers, as well as by co-feeding levels, neither parent sex nor co-feeding levels significantly moderated relationships between parent feeding and child eating variables.

CONCLUSIONS

Future studies of food and snack parenting and co-operation in relation to feeding among mothers and fathers within a familial unit may be critical to identify intervention strategies that draw on all family resources to better navigate future disruptive events such as the COVID-19 pandemic.

Daily variability in mothers' and fathers' feeding practices and associations with children's eating behaviors

The current study explores daily variability in maternal and paternal pressuring, restrictive, and structure-related feeding practices and their associations with child energy regulation and food refusal. Multilevel models were run separately for mothers and fathers to understand these associations, as well as within a dyadic framework to account for the interdependence of partners. One hundred families with at least one child between 3- to 5-years old participated by completing seven days of daily diaries. Results suggest there is daily variability in feeding practices for mothers and fathers and children's energy regulation and food refusal. Mothers' daily reports (within family variability) suggested that on days when mothers used more pressure and less structure than usual, children showed more food refusal. Fathers' daily reports suggested that on days when fathers used more pressure or less structure, children showed less energy regulation. On average across the week (between family variability), maternal pressure and restriction was related to child energy regulation. Dyadic multilevel models suggested that fathers' daily feeding behavior was associated with child eating behavior, while mothers' pressure and restrictive feeding on average across the week was a better predictor of between family variability in child eating behavior. For provision of support or structure during feeding, maternal structure was related to less father-reported energy regulation and paternal structure was related to more father-reported energy regulation. The results highlight the necessity of considering both mothers' and fathers' behaviors from day-to-day to get a more authentic picture of the family feeding relationship.

The Lived Experiences of Fathers in Mealtimes: A Thematic Synthesis of Qualitative Literature

The paternal experience of family mealtimes is an emerging field within qualitative literature. Previous quantitative studies suggest that differences exist between fathers’ and mothers’ mealtime behaviours, particularly in response to fussy eating. However, qualitative research has not yet focused exclusively on fathers’ fussy eating experiences. This metasynthesis aimed to provide insights into the general paternal experience, inclusive of their fussy eating responses. Thematic synthesis methodology was adopted to achieve this process and consisted of a systematic search resulting in the inclusion of 16 studies (18 papers). The direct quotations presented within each study were subjected to three stages of analysis to produce three analytical themes, supported by eight descriptive themes. The analytical themes presented were: (1) environmental influences on fathers’ mealtime experiences; (2) attitudes and emotions of fathers during mealtimes; and (3) observable behaviours of fathers during mealtimes. These themes highlighted the complexity of the mealtime experience from a paternal perspective. Multidirectional relationships were identified between each mealtime component (i.e., the environment, attitudes, emotions and behaviours) as evidenced by the paternal commentary presented. The findings also provided insights into fathers’ fussy eating experiences, recognising that fathers should be considered as individuals in the presence of mealtime intervention.

Feeding coparenting: Associations with coercive control, structure-based, and autonomy-promoting food parenting

Feeding coparenting refers to how two parents work together in the child feeding domain. However, little is known about feeding coparenting in relation to food parenting. The current study seeks to examine 1) whether parent demographics (i.e., sex, age, BMI, and employment status) and parent concern about child weight are related to feeding coparenting (i.e., Shared Views, Active Engagement, Solo Parenting) and 2) whether feeding coparenting is related to food parenting (i.e., coercive control feeding, structure-based feeding, autonomy-promoting feeding). Parents (n = 160) of 3- to 5-year old children completed an online survey. Parents' sex, employment status, and concern about child weight were related to feeding coparenting (Shared Views, Active Engagement, Solo Parenting). After controlling for those variables, feeding coparenting was related to structure-based (Shared Views and Active Engagement) and autonomy-promoting feeding (Active Engagement). However, none of the feeding coparenting variables were associated with coercive control feeding. These findings illuminate the importance of understanding how parents' feeding coparenting relationship plays a part in food parenting.

Associations between Coparenting Quality and Food Parenting Practices among Mothers and Fathers in the Guelph Family Health Study

Coparenting quality and food parenting practices have been shown to have a strong influence on child outcomes. However, little is known about whether coparenting quality may influence food parenting practices. This study aimed to investigate how coparenting quality is associated with both mothers’ and fathers’ food parenting practices. A cross-sectional analysis was conducted of 58 mothers and 40 fathers enrolled in the Guelph Family Health Study. The Coparenting Relationship Scale and the Comprehensive Feeding Practices Questionnaire were used to measure coparenting and food parenting practices, respectively. Linear regressions using generalized estimating equations were used to examine associations between coparenting quality and food parenting practices in mothers and fathers. Among mothers, higher coparenting quality was associated with lower use of food for emotional regulation, restriction of food for health, and child control of food intake and with higher encouragement of a balanced and varied diet, provision of a healthy home environment, and modeling of healthy eating behaviors. Among fathers, higher coparenting quality was associated with lower pressure to eat and with higher encouragement of a balanced and varied diet and provision of a healthy home environment. Coparenting quality is associated with food parenting practices among both mothers and fathers. Interventions aiming to improve food parenting practices should include fathers and should consider targeting parents’ coparenting relationship.

Pediatrician's Beliefs and Practices Around Rapid Infant Weight Gain: A Qualitative Study

Rapid infant weight gain is a risk factor for later obesity. The objective of this study was to examine primary care pediatricians’ beliefs and practices around rapid infant weight gain. Primary care pediatricians (N = 16) participated in a semi-structured interview about infant growth. Interviews were transcribed, analyzed for themes using the grounded theory and the constant comparative method then reliably coded for the presence of each theme. Three themes were identified, pediatricians (1) are uncertain about the concept, definition, and implications of excessive or rapid infant weight gain (N = 16, 100%), (2) are more comfortable with management of inadequate versus excessive or rapid weight gain (N = 10, 62.5%), and (3) perceive the primary cause of excessive or rapid infant weight gain to be overfeeding (N = 10, 62.5%). In conclusion, pediatricians are uncertain about the concept, definition, management, and long-term risks of rapid infant weight gain. Interventions to increase awareness and pediatrician sense of competence in management of rapid infant weight gain are needed.

Investigating the Efficacy of Genetic, Environmental, and Multifactorial Risk Information When Communicating Obesity Risk to Parents of Young Children

BACKGROUND

Effectively communicating with parents about children's obesity risk is of critical importance for preventive medicine and public health.

PURPOSE

The current study investigates the efficacy of communications focused on two primary causes of obesity: genes and environment.

METHODS

We compared parental feeding responses to messages focused on (i) genetics alone, (ii) family environment alone, (iii) genetics-family environment interaction (G × FE), and (iv) no causal message. We also examined whether parental guilt mediates the effect of message type on feeding. Our sample consisted of 190 parents, half mothers and half fathers, of children 3-7 years old. After receiving one of the four types of messages, parents chose foods for their child using the Virtual Reality Buffet measure. Parents responded to questionnaires in the lab and at 1-week follow-up.

RESULTS

In the VR Buffet, parents did not feed their children differently in message provision conditions versus control. There were, however, differences among message provision conditions wherein mothers who received any genetic information chose higher-calorie meals in the VR Buffet. At 1-week follow-up, parents who received information about genetics alone reported feeding their child more junk food and fatty meat on self-report food frequency assessments; there were no such differences for sugary beverages, sugary foods, or fast foods. Parental guilt was typically higher for participants who received family environment information alone but did not mediate the relation between information provision and feeding outcomes.

CONCLUSIONS

While none of the messages improved feeding above the control condition, GxFE messages were associated with a better overall profile of outcomes. As such, it may be beneficial for messaging for parents about children's obesity risk to include content that reflects the complexity of genetic and environmental contributions to obesity risk.

Feeding in the Digital Age: An Observational Analysis of Mobile Device Use during Family Meals at Fast Food Restaurants in Italy

Caregiver mobile phone use while monitoring children is a behavior of increasing prevalence. Family mealtimes have long been considered a time in which parents and children connect emotionally and model eating behaviors, but prior studies have documented less parent-child conversation and more negative parent reactions to child behavioral bids at the table during parent phone use. Research on this topic to date is sparse and focuses only on US populations. The current study used non-participant naturalistic observation to record data on parental mealtime device use and family interactions while dining with children in a fast food restaurant in Italy. Thirty seven families (individuals observed = 129) were observed at a restaurant for the duration of their meal. Qualitative analysis of field notes indicated that mobile phones are frequently used by caregivers during feeding interactions. A novel observation in the current study was different patterns of use by parent gender and age. Mothers appeared to divide their attention between phone and child, whereas fathers evidenced more continuous mobile phone use during which there was lower responsiveness towards children during the meal. Younger parents more frequently used mobile phones, compared to older parents. Parents who missed child bids for attention were all phone users during the mealtime.