Maternal perception, concern and dissatisfaction with child weight and their association with feeding practices in the Generation XXI birth cohort

Maternal Perceptions and Feeding Practices Associated with Infant Nutritional Status

INTRODUCTION

Malnutrition in early childhood has long-term health consequences, including increased obesity risk due to catch-up growth in undernourished infants. While maternal perceptions and feeding practices affect infant malnutrition, limited evidence exists in middle-income countries like Mexico. This study examines the associations between maternal perceptions, feeding practices, and nutritional status in infants aged 6-12 months in northeastern Mexico.

METHODS

A total of 192 mother-infant dyads were assed using questionnaires and anthropometric measurements. Maternal variables included perception of hunger and satiety, infant weight perception, feeding attitudes, self-efficacy, fatigue, and feeding practices. Infant nutritional status was determined using WHO Anthro, and multiple logistic regression identified associations between maternal and infant factors and nutritional status.

RESULTS

38% of infants were overweight/obese, and 7% were underweight. Low maternal self-efficacy, low perception of hunger and satiety signs, non-recommended feeding attitudes, and inaccurate perception of infant weight were identified. Maternal nocturnal sleep hours, type of feeding, and feeding frequency were associated to underweight. The maternal perception of infant weight was inaccurate for both underweight (mothers overestimate the weight) and overweight/obese (mothers underestimate the weight) infants.

DISCUSSION

The main maternal perception influencing infant nutritional status was inaccurate weight perception. Mothers demonstrated limited knowledge and negative feeding practices with non-recommended feeding practices among Mexican mothers. Longer maternal sleep duration (> 8 h/night) was associated with underweight infants.

Maternal misperception of under-five children weight status and associated factors: A cross-sectional study

Maternal perceptions, about the nutritional status of their children, may have implications for timely health care seeking and feeding behaviour. Shreds of evidence are limited in this area that assessed maternal perception about the nutritional status of the children in the context of Bangladesh. The objective of this study is to assess the differences in mothers' perceptions about their children's nutritional status who are less than 5 years of age and their associated factors in the context of urban slum areas. A cross-sectional study (Quantitative approach) was conducted in two of the largest urban slums of Dhaka city. A total of 437 mother-children dyads were included in the final analysis. The outcome of interest was the mother's 'varied perceptions' regarding the nutritional status of their children under five. 'Varied perception' refers to the difference between a mother's subjective assessment of her child's nutritional condition and the anthropometrically measured nutritional status. The prevalence of mother's varied perceptions was around 46%, and among them, 37% of mothers underestimated and 9% overestimated their child's nutritional status. 'The child doesn't want to eat' (AOR = 3.69; 95% CI: 2.34-5.85; p < 0.001) and 'Feels light when carried' (AOR = 3.39; 95% CI: 1.69-6.81; p = 0.001) were the significant reasons behind the mother's perception about the nutritional status of their under-five children. About one in two mothers' perceptions about their children varied from the anthropometry-derived status. Various research findings indicate that providing health education on proper feeding practices for children, along with anthropometric measurements, can assist mothers in enhancing their understanding and assessing their child's nutritional status with greater accuracy. Further qualitative research may be instrumental in getting deeper insights into maternal perception to develop context-specific interventions.

Maternal-child overweight relationship, assessment of maternal perception of child weight status and feeding behaviours

BACKGROUND

Parents play a key role in constructing children' behaviours. We studies maternal-child overweight relationship and compared maternal perception of child weight status and feeding behaviours between groups of normal-weight and overweight children.

METHODS

The cross-sectional study was conducted on 192 girls aged 10-13 years and their mothers. They were divided to two groups of overweight (n = 94) and normal-weight (n = 98) children. Anthropometric characteristics were measured for children and mothers. Logistic regression analysis was used to examine the association between child overweight and tertiles of maternal body mass index (BMI). Maternal perception of child's weight status and her engagement in promoting child's healthy behaviours was assessed.

RESULTS

BMI and waist circumference was significantly higher in children (P < 0.001) and mothers (P < 0.01) of overweight compared to normal-weight group. There was a significant relationship between children's overweight and tertiles of maternal BMI, which remained significant after adjusting for potential confounders. Mothers of overweight children were more concerned for their child's overeating and overweight, and for compelling the child to diet to maintain a desirable weight (P < 0.001). In contrast, mothers of normal-weight children restricted sugar-sweetened drinks (P = 0.008), offered fruit and vegetables (P = 0.035), and helped their children to get enough physical activity (P = 0.022) and night sleep (P = 0.001) more than mothers in other group.

CONCLUSIONS

This study showed a strong relationship between children and mothers' overweight. Despite being more concerned about their child weight status, mothers of overweight children reported behaviours which were less encouraging the children for healthy eating and lifestyle than mothers of normal-weight children.

The Association of Parental Feeding Practices, Parental Control Over children's Eating Behavior, and Sociodemographic Characteristics with Childhood Overweight and Obesity in Türkiye

Parents both respond to and influence their child's weight. This study aimed to investigate the association of parental feeding practices, parental control over children's eating behavior, and sociodemographic characteristics with childhood overweight and obesity. This descriptive cross-sectional study was conducted with 405 parents of children aged 7-11 years. Predictors that decreased the risk of childhood overweight/obesity were increase in child age (27.9%), high maternal education (61.7%), upper socioeconomic status (38.9%), increase in parental covert control (30.4%), and increase in parental pressure to eat (46.2%). Examining both parental attitudes and practices regarding child feeding and parental approaches to child food choices can benefit early intervention programs to prevent overweight and obesity in children.

Less underestimaton of excess weight by the categorical than the visual method. Its determinants and feeding practices in Mexican mothers of children aged 2 to 12 years

Introduction

Introduction: perceived body weight refers to the subjectively assessed weight, which may not correspond to the objectively measured weight. Statistics show that 14 % to 83 % of parents misperceive their children's weight status, with a propensity for underestimation. Objective: we compared the accuracy of the visual versus the categorical method. We also identified factors and feeding practices associated with excess weight underestimation. Material and methods: we carried out a cross-sectional study in five states of Mexico with 1,845 mother-child dyads of children aged 2-12 years. The mothers were interviewed about weight perception with two methods, visual and categorical. The Child Feeding Questionnaire identified maternal feeding practices. Actual weight and height were categorized according to WHO criteria. Analysis consisted of Cohen's kappa estimation, multivariate logistic regression, and Mann-Whitney tests. Results: more mothers correctly identified the weight of their children with the categorical than with the visual method (68 % vs 42 %, p < 0.0001). The excess weight underestimation was lower (49 % vs 82 %, p < 0.0001) and the degree of agreement was higher with the categorical method (kappa, 0.39 and 0.08). The better results remained regardless of age. Age 2-5 years increased the odds of overweight/obesity underestimation. Feeding practices differed by weight perception category, child's age, and method of assessment. Conclusions: the categorical method was more accurate. Recognition of correct weight perception is one of the first actions required for controlling childhood overweight/obesity.

Mother-child pairs' eating and feeding behaviours in two different nutritional status from two distinct provinces

Nutrition plays a crucial role for the bio-psycho-social growth and development of children. Mother-child pairs' eating-feeding problems can be hypothesized to relate to the child's nutritional status and living area. Our focus was to assess maternal attitudes and children's eating habits in thin and normal-weight children across two cities characterized by distinct socioeconomic and demographic profiles: Ankara and Şanlıurfa. This double case-control study included the mothers whose children are aged between 2 and 7 years old in both cities. Figure Rating Scale, Child Feeding Questionnaire and Behavioral Pediatrics Feeding Assessment Scale were filled by mothers of children. The mothers of thin children were concerned more about the weight of their children, felt more responsible for feeding their children, and use of pressured them to eat more frequently compared to normal-weight children's mothers in both cities. In Ankara, the duration of breastfeeding is longer, using formula is rarer and starting complementary food on time is more common, mother had higher scores on perceived responsibility, perceived child weight, and concern about child weight subscales; lower score on the restriction subscale compared to Şanlıurfa. Mothers of both thin and normal weight children in Şanlıurfa rated their children as weaker compared to those in Ankara. In conclusion, child eating behaviors and parental feeding practices were associated with the weight of children depending on demographic and sociocultural differences. Implementing customized, location-specific preventive educational initiatives on child feeding will not only foster behavioral changes but also yield valuable insights for shaping future interventions.

Comparing the use of food and physical activity parenting practices: Parents of children with overweight and obesity versus parents of children with a healthy weight

Background

Paediatric overweight and obesity are caused by a complex imbalance between energy intake and expenditure. Parents may influence this imbalance through energy balance-related parenting practices. This study aims to compare the use of energy balance-related parenting practices between parents of children with overweight and obesity and children with a healthy weight.

Methods

This study compares energy balance-related parenting practices among a group of parents with children with overweight and obesity at the start of a lifestyle intervention (N = 107) and children with a healthy weight (N = 137). Specifically, it compares the feeding practices 'overt control' (open control over eating), 'encouragement', 'instrumental feeding', 'emotional feeding', and 'covert control' (hidden control over eating), as well as the physical activity parenting practice 'promoting physical activity'. Multiple regression analyses are used to calculate associations between child weight groups and parenting practices when corrected for children's characteristics.

Results

Parents of children with overweight and obesity reported significantly different scores on control over eating practices than parents of children with a healthy weight, namely a significantly higher score on covert control (B = 0.397, S.E. 0.123, p = 0.001) and a significantly lower score for overt control (B = -0.136, S.E. 0.068, p = 0.046).

Conclusion

Covert control is reported more, while overt control is reported less in parents of children with overweight and obesity compared to parents of children with a healthy weight, even after correction for the child's, family, and maternal characteristics. Future longitudinal research and intervention trials are recommended to determine whether and how the use of control over eating practices changes.

Parental Feeding Practices and Children's Eating Behaviours: An Overview of Their Complex Relationship

Several studies have found an association between eating behaviours and weight status and obesity risk in childhood. Children's eating behaviours arise from a combination of genetic and environmental factors. Parents appear to play a central role in their development as the main responsible for shaping children's feeding environment and eating experiences. The purpose of this paper is to review the literature on parental influences on eating behaviours across childhood, mainly focusing on parental feeding practices. The associations between parental feeding practices and children's eating behaviours have been extensively studied. However, most of the findings come from cross-sectional studies, so the possibility of reverse causality cannot be ruled out (i.e., children's behaviours influencing parents). Most recently, a few longitudinal studies with a cross-lagged design have shown that the relationship between children's eating behaviours and parental feeding practices seems to be bidirectional, where it is not straightforward whether parental feeding practices are a predictor or a consequence of children's eating behaviours. Children's eating behaviours influence parents to adopt certain feeding practices, but these practices also influence children's behaviours over time. Parental feeding practices may have the potential to shape children's eating behaviours and should be targeted to promote the development of non-obesogenic traits. However, parent-child interactions are complex and therefore both parent and child characteristics and the family dynamics should be considered.

The Relationships between Caregivers’ Concern about Child Weight and Their Non-Responsive Feeding Practices: A Systematic Review and Meta-Analysis

Background: It is unclear whether caregivers’ concern about child weight impacts their non-responsive feeding practices. This systematic review aimed to examine their relationships. Methods: A systematic search of PubMed, Embase, PsycINFO, Web of Science core collection, CINAHL and grey literature was conducted from inception to March 2022, following PRISMA guidelines. Data synthesis was performed using a semi-quantitative approach and a meta-analysis. Results: A total of 35 studies with 22,933 respondents were included in the review for semi-quantitative analyses. Thirty-four studies examined 52 associations between concern about child weight and restriction with 40 statistically significant associations being observed. A total of 34 relationships between concern about child weight and pressure to eat were investigated, with 12 being statistically significant. The pooled regression coefficients (β) demonstrated that caregivers’ concern about child overweight was positively associated with restriction (β = 0.22; 95%CI: 0.12, 0.31), negatively associated with use of food as a reward (β = −0.06; 95%CI: −0.11, −0.01), and not statistically associated with pressure to eat (β = −0.05; 95%CI: −0.13, 0.04). The pooled odds ratios (ORs) indicated that caregivers who were concerned about child overweight were found to use restrictive feeding more often (OR = 2.34; 95%CI: 1.69, 3.23), while less frequently adopting pressure to eat (OR = 0.76; 95%CI: 0.59, 0.98) compared with those without concerns. The results also showed that caregivers who were concerned about child underweight were more likely to force their children to eat (OR = 1.83; 95%CI: 1.44, 2.33) than those without concerns. Conclusion: Caregivers’ concern about child weight may be an important risk factor for non-responsive feeding practices. Thus, interventions are needed to focus on managing and relieving caregivers’ excessive concern about child weight, especially overweight, which may optimize feeding practices and subsequently contribute to child health.

Mothers' accounts of mealtime and feeding challenges for children with Tourette syndrome or persistent tic disorders

Parenting a young person with a tic disorder can present daily challenges to families struggling to manage their child's tics and establish routines. Research recognises that tics can be problematic to everyday activities, however no attention has been given to mealtimes, arguably an important family activity closely related to quality of life of the family. The current qualitative study aimed to investigate the mealtime experiences of families with a child with a tic disorder from the perspective of mothers, looking at mealtime challenges, their impact and how these challenges are navigated. Seventeen mothers with children diagnosed with Tourette Syndrome (TS) or a Persistent Tic Disorder (PTD) (aged 3-14) took part in semi-structured interviews. Interpretative phenomenological analysis of 17 semi-structured interviews resulted in seven subthemes which were grouped under two superordinate themes: (1) tics as a barrier to positive mealtime experiences and (2) eating behaviours and other mealtime challenges. The findings highlight tics to create functional mealtime challenges, affecting a young person's ability to eat, drink and be seated, with mothers noting the family dynamic was often intensified and compounded by additional challenges related to their child's tics and comorbidities. Tics also have the power to disrupt the conviviality of mealtimes. For example, eating out-of-home can be especially challenging, with restaurants being high-pressure environments for young people with tics and their families. The cumulative effect of dissatisfaction, stress and additional foodwork can have a diminishing effect on maternal and familial resilience and wellbeing. Mealtime-related interventions need to be considered to help increase confidence and skills in managing mealtimes.

Parental feeding practices and parental involvement in child feeding in Denmark: Gender differences and predictors

Studies about fathers and feeding are scarce and little is known about predictors of parental involvement in child feeding and of paternal feeding practices. Therefore, this study aimed to examine possible differences between Danish mothers and fathers with regard to their feeding practices and involvement in feeding related tasks, and to assess possible parent-related predictors of parental practices and involvement. A total of 261 mothers and 321 fathers of pre-schoolers completed an online survey with items from validated questionnaires. Gender differences were observed; fathers reported using higher levels of coercive control practices, while mothers reported using higher levels of structure practices and autonomy support practices. Both mothers and fathers reported to be highly involved in feeding their child. Regressions showed that a higher concern for child weight and a higher motivation for child preference when buying food were linked to a higher use of coercive control practices while a higher motivation for health control when buying food, cooking confidence, feeding/general self-efficacy and perceived responsibility for feeding were linked to a higher use of structure and autonomy support practices. The results of this study provide valuable insight into maternal and paternal practices in Denmark and their determinants.

Association between Parents' Perceptions of Preschool Children's Weight, Feeding Practices and Children's Dietary Patterns: A Cross-Sectional Study in China

Parental perception of children's weight may influence parents' feeding practices, and in turn, child dietary intake and weight status; however, there is limited evidence generated for preschoolers. The aim of this cross-sectional study was to investigate associations between Chinese parents' perceptions of child weight, feeding practices and preschoolers' dietary patterns. Participants (1616 parent-child pairs) were recruited from six kindergartens in Hunan, China. Parents' misperception, concern, and dissatisfaction on child weight were collected through a self-administered caregiver questionnaire. Parental feeding practices and children's dietary intake were, respectively, assessed using the Child Feeding Questionnaire and a Food Frequency Questionnaire. Linear regression models were applied to analyze associations between parental weight perceptions, feeding practices, and preschooler's dietary patterns. Associations between parents' weight perceptions and dietary patterns were significant only among underweight children. Regardless of child weight status, parental weight underestimation and preference for a heavier child were positively associated with pressure-to-eat. Parental weight concern was positively associated with restriction in normal weight child, but this was not found in other weight groups. In conclusion, Parents' misperception, concern, and dissatisfaction about child weight are associated with parents' feeding practices and may influence preschoolers' dietary quality, but the relationships vary by children's actual weight status.