Associations between father availability, mealtime distractions and routines, and maternal feeding responsiveness: An observational study

Mothers' reflections on family food habits post pandemic

The COVID-19 pandemic altered daily family routines, with the family food environment especially likely to be affected. Little is known about how families have adapted over time. The objective of the current study was to explore how family food habits evolved three years after COVID-19 was designated a pandemic. Mothers participated in an interview between March and April 2023. Reflexive thematic analysis was used to analyze the transcripts. Thirty mothers participated (97% lived in the Central Valley in California; 43% Hispanic). Themes were identified around changes in mealtime frequency, eating habits including snacking, screen time during mealtimes, and weight gain. While some unhealthy habits established during the pandemic improved, others persisted three years later. Maternal snacking, concerns about child weight gain, and overall screen time lessened after the pandemic ended, but child snacking behaviors, maternal weight gain concerns, and screen time during mealtimes continued. This research expands on the existing COVID-19 literature by examining lingering effects of the pandemic on family food habits. Findings may be helpful for health practitioners working with families to understand food related changes post-pandemic, especially those that have been particularly resistant to change.

Protective role of family mealtime frequency against disordered eating behaviors: Racial and ethnic differences

Family mealtimes have been recognized for their positive effect on child and adolescent health outcomes. Frequent family meals have been shown to have protective effects in reducing disordered eating behaviors, but the variability of these effects across different racial and ethnic backgrounds has been less explored. To address the gap, the current study utilizes a sample of 33,417 families with children (ages 6-17) in the United States who participated in the 2022 National Surveys of Children's Health (NSCH). Logistic regressions were conducted to examine the association between family mealtime frequency and the manifestation of disordered eating across youth from diverse racial/ethnic backgrounds. Our findings revealed that frequent family mealtimes are associated with a lower risk of engaging in disordered eating behaviors in youth. However, there were disparities in the associations between family mealtime frequency and the prevalence of disordered eating behaviors among children from different racial/ethnic backgrounds. Youth who never participated in family mealtimes were at a greater risk of engaging in disordered eating behaviors among those identifying as non-Hispanic Black or of 'other' racial groups. In youth identifying with multiple races, the frequency of family was not associated with the odds of disordered eating behaviors. The results provide insights into the nuanced influence of family mealtime frequency on disordered eating based on diverse racial/ethnic groups. This highlights the need for future studies to identify factors associated with racial/ethnic identities that may contribute to disordered eating behaviors in youth to identify the unique needs and challenges faced by families in leveraging the protective effect of family mealtimes.

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.

Impacts of Parental Technoference on Parent-Child Relationships and Child Health and Developmental Outcomes: A Scoping Review

Parental technological immersion during parenting activities has been shown to alter parent-child interactions. This concept, referred to as parental technoference, has the potential to affect parent-child relationships and children's health and development. This scoping review utilized the Joanna Briggs Institute (JBI) methodology to identify, describe, and summarize: (a) evidence of parental technoference on parent-child relationships, and children's health and development; (b) definitions and measurements of parental technoference; (c) research designs and methodologies used to investigate parental technoference; and (d) literature gaps. We searched MEDLINE, APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database for Systematic Reviews, JBI EBP Database, Embase, CINAHL, and Scopus, as well as the reference lists of included studies for literature on parental technology use during parenting and parent-child interactions and its effects on parent-child relationships, and children's health and development. Sixty-four studies, found in 61 publications, met the review criteria. The effect of parental technoference on parent-child relationships was most studied, and findings demonstrated that parents recognized, and researchers observed, changes in parents' and children's behaviors. Adolescent self-reported mental health concerns and maladaptive technological behaviors (e.g., cyberbullying) were associated with more parental technoference, and findings highlighted safety concerns for children. Other aspects of children's development, although less studied, were also negatively impacted by parental technoference. No significant associations were found between parental technoference and children's medical and physiological health, yet these associations were the least studied. Additional research is needed to understand these associations and evaluate interventions designed to mitigate technoference harms.

Are Complementary Feeding Practices Aligned with Current Recommendations? A Narrative Review

The complementary feeding introduction period (introduction of solid foods alongside breastmilk or formula) is defining in children's health; however, it appears that many parents do not follow complementary feeding guidelines. Our aim was to describe current parental feeding practices during complementary feeding in relation to current recommendations and explore determinants of adherence to guidelines. We included any relevant studies published within the last decade in French or English and summarized findings by recommendation category. The timing of complementary food introduction varied widely across and within continents (earlier in North America and often delayed in Asia). The introduction of allergenic foods tended to be delayed globally. Although some parents now begin complementary feeding with solid foods (i.e., baby-led weaning), delayed introduction of lumpy textures was still prevalent in the United States and in Europe. The consumption of iron-rich foods was predominantly low in Africa. Added sugars were globally introduced early, especially in America. Evidence for the prevalence of responsive feeding practices among parents is unclear due to the small number of studies. Determinants of complementary feeding practices included parental characteristics, such as age, education, socio-economic status, and race/ethnicity. Interventions aiming to increase adherence to complementary feeding guidelines must account for parental characteristics.

Applying a family stress model to understand U.S. families' patterns of stress, media use, and child behavior during the COVID-19 pandemic

The COVID-19 pandemic has greatly altered family life, and research among adults and families is finding increases in financial stress, mental health problems, screen time, parental conflict, and child behavior problems. Given these patterns, we sought to replicate these findings with a younger and largely non-white sample and consider how these constructs might relate to each other by using the Family Stress Model. From surveys of 247 predominately Latine mothers and fathers of children under 4 years in the U.S., we found that financial strain was related to children's media exposure and use, largely through impacts on parents' mental health and coparenting relationship. Interestingly, only use of television in the background and during mealtimes were associated with increases in children's behavior problems. Such findings better capture how stress may operate in a family system and offer a way to counsel parents about healthier media habits for children.

Children's media use and food approach behavior: Associations with temperament and food parenting

Children's media use has been found to be associated with obesogenic eating and obesity risk. Children's temperament and food parenting have been found to be important factors associated with children's eating behavior. The current study examined whether children's temperament and food parenting moderated the associations between children's media use and children's food approach behaviors. Parents (n = 214) of children between 3- to 5- years old were recruited to complete an online survey. Findings showed that children's temperament (i.e., negative affectivity and effortful control) and food parenting (i.e., coercive control) moderated the relationship between children's media use and children's food approach behavior. The results suggest that children's temperament and food parenting play important roles in understanding the relationship among children's media use and children's eating behavior.

Infant temperament and mealtime distractions as predictors of preschool Children's bite speed during family mealtime

Eating behaviors are shaped at an early age, persist into adulthood, and are implicated in the development of physical health outcomes, including obesity. Faster bite speed has been identified as an obesogenic eating behavior, prompting researchers to examine child and family factors associated with children's variability in bite speed. Child temperament, involving phenotypes of reactivity and regulation, and distractions in family food contexts are fruitful areas of investigation, but few studies have examined the interplay among these factors and their associations with bite speed. To address the gap in the literature, we examined relations between early child temperament, family mealtime distractions, and children's observed bite speed. Caregiver report of child temperament at 3 months was measured using the Infant Behavior Questionnaire Very Short Form - Revised. Child mealtime distractions and bite speed were assessed using family mealtime videos that were collected during home visits when children were 18-24 months of age (n = 109). Results revealed that children who were reported to be higher on orienting/regulation at 3 months, and who were more distracted during mealtimes at 18-24 months, had relatively slower bite speeds. No significant interactions were found. The findings from this correlational study inform further investigations into the implications of early temperament and food contexts for the development of eating behaviors implicated in obesity risk.

Child meal microstructure and eating behaviors: A systematic review

Observational coding of children's eating behaviors and meal microstructure (e.g., bites, chews) provides an opportunity to assess complex eating styles that may relate to individual differences in energy intake and weight status. Across studies, however, similar terms are often defined differently, which complicates the interpretation and replication of coding protocols. Therefore, this study aimed to compile methods of coding meal microstructure in children. To limit bias and ensure a comprehensive review, a systematic search was conducted in January 2021 across three databases (PubMed, PsychInfo, Web of Science) resulting in 46 studies that coded at least one meal-related behavior in healthy children (i.e., no medical/psychological disorders) who were able to self-feed (i.e., no spoon-, breast-, or bottle-feeding). While the majority of studies had good interrater reliability, the details reported about study foods and the clarity of the definitions used for behavioral coding varied considerably. In addition to reported microstructure behaviors, a non-exhaustive review of individual differences was included. While few studies reported individual differences related to age and sex, there was a larger literature related to weight status that provided evidence for an 'obesogenic' style of eating characterized by larger Bites, faster Eating and Bite Rates, and shorter Meal Durations. However, some studies may not have been optimally designed or powered to detect individual differences because they did not set out a priori to examine them. Based on this systematic review, best practices for the field are recommended and include reporting more details about foods served and coded eating behaviors to improve reproducibility. These suggestions will improve the ability to examine patterns of individual differences across studies, which may help identify novel targets for 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.

Barriers and enablers to caregivers' responsive feeding behaviour: A systematic review to inform childhood obesity prevention

Responsive infant feeding is a critical component of childhood obesity prevention. However, there is little guidance for caregivers on how to do this successfully. The first step to developing an intervention to promote responsive feeding is to systematically identify its barriers and enablers. Searches were conducted in CINAHL, Cochrane Library, Medline, Embase, PubMed, PsycINFO, Maternity, and Infant Care from inception to November 2020. All study designs were included if they reported a barrier or enabler to responsive feeding during the first 2 years of life. We used a "best fit" framework synthesis, with the Capacity, Opportunity, Motivation, and Behaviour (COM-B) model. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality. Forty-three studies were included in the review. Barriers (n = 36) and enablers (n = 21) were identified across five COM-B domains: psychological capacity, physical and social opportunity, and reflective and automatic motivation. Enablers were recognition of infant feeding cues, feeding knowledge and family and friends. Caregiver attitude toward control of feeding was a barrier, together with health care professional advice about formula feeding and breastfeeding expectation. These barriers and enablers provide a comprehensive evidence base to guide intervention development to improve responsive feeding and prevent obesity across individual and population levels.

Parental phone use during mealtimes with toddlers and the associations with feeding practices and shared family meals: a cross-sectional study

BACKGROUND

Positive parental feeding practices and a higher frequency of family meals are related to healthier child dietary habits. Parents play an essential role when it comes to the development of their child's eating habits. However, parents are increasingly distracted by their mobile phone during mealtimes. The aim of this study was to describe the feeding practices and daily shared family meals among parents who use and do not use a mobile phone during mealtimes, and further to explore the associations between the use of a mobile phone during mealtimes and feeding practices and daily shared family meals, respectively.

METHODS

Cross-sectional data from the Food4toddler study were used to explore the association between mobile use during meals and parental feeding practices including family meals. In 2017/2018 parents of toddlers were recruited through social media to participate in the study. In total 298 out of 404 who volunteered to participate, filled in a baseline questionnaire, including questions from the comprehensive feeding practices questionnaire (CFPQ), questions of frequency of family meals and use of mobile phone during meals.

RESULTS

Herein, 4 out of 10 parents reported various levels of phone use (meal distraction) during mealtimes. Parental phone use was associated with lower use of positive parental feeding practices like modelling (B = - 1.05 (95% CI -1.69; - 0.41)) and family food environment (B = - 0.77 (95% CI -1.51; - 0.03)), and more use of negative parental feeding practices like emotional regulation (B = 0.73 (95% CI 0.32; 1.14)) and the use of pressure to eat (B = 1.22 (95% CI 0.41; 2.03)). Furthermore, parental phone use was associated with a lower frequency of daily family breakfast (OR = 0.50 (95% CI 0.31; 0.82)) and dinner (OR = 0.57 (95% CI 0.35; 0.93)).

CONCLUSIONS

Mobile phone use is common among parents during mealtimes, and findings indicate that parental phone use is associated with less healthy feeding practices and shared family meals. These findings highlight the importance of making parents aware of potential impacts of meal distractions.

TRIAL REGISTRATION

ISRCTN92980420 . Registered 13 September 2017. Retrospectively registered.

Family Meals, Conviviality, and the Mediterranean Diet among Families with Adolescents

Two aspects that characterize the Mediterranean diet (MD) are "what" and "how" we eat. Conviviality relates to "how" we eat and to the pleasure of sharing meals with significant people. The most studied concept is "family meals", which includes conviviality, which involves "enjoying" family meals. Given the lack of research on convivial family meals in Mediterranean countries, the purpose of this qualitative study was to analyze the family meal representations and practices of families with 12- to 16-year-old adolescents to assess whether they responded to a pattern of conviviality, and to examine their association with MD adherence. Twelve semi-structured interviews were conducted and food frequency and family meal questionnaires were administered. A food pattern analysis was carried out and digital photos of meals were analyzed to examine eating habits and meal composition, respectively. The findings showed that parents believed family meals are a space for socialization and communication. Items relating to the conviviality of family meals identified in the study were meal frequency, meals at the table, lack of digital distractions, pleasant conversations, and time spent on family meals. Attention should be paid to conviviality in Mediterranean families when designing multi-approach strategies to promote healthy eating among adolescents.

Child attachment behavior as a moderator of the relation between feeding responsiveness and picky eating behavior

BACKGROUND

Picky eating (PE) behavior is common in early childhood, but persistent PE is associated with unhealthy development and caregiver-child stress during feeding. Identifying modifiable feeding and parent-child relationship factors that impact PE is important for decreasing risks associated with PE.

OBJECTIVE

This study examined associations between caregiver Feeding Responsiveness (FR) and child PE behaviors using caregiver reports and observations of family mealtimes. An additional aim examined whether children's attachment behavior moderates this association.

METHODS

The analysis sample consisted of 110 families participating in a larger longitudinal study of nutrition and child health. Home observations were conducted when children were 18-24 months (52% females) to assess caregiver-child interactions. Caregivers were, on average, 30.9 years old and mostly White (73.6%). Family mealtimes were videotaped and coded for FR and child PE behaviors. Caregivers completed surveys regarding FR and PE behaviors.

RESULTS

Caregiver-reported FR was significantly correlated with observed FR, r (107) = 0.26, p = 0.007; and caregiver-reported PE was associated with observed PE, r (107) = 0.21, p = 0.029. Caregiver-reported FR was inversely related to observed PE, but only when children were characterized by observers to have more positively toned and smooth interactions with caregivers. Using observational data, child attachment significantly moderated the relationship between FR and PE behaviors.

CONCLUSIONS

The quality of caregiver-child interactions may impact the degree to which FR is effective in reducing PE. Future longitudinal studies that include more diverse populations, multiple caregivers, and potential mechanisms accounting for these associations are needed.

Rural Midwestern Mexican Fathers' Perspectives on Family Food, Mealtimes, and Physical Activity

Two focus group interviews with eight low-income Mexican fathers in two communities in a rural Midwestern state explored fathers' perceptions, behaviors, and roles related to child and family food consumption, mealtimes, and physical activity. On average, fathers were 34 years of age, had 10 years of formal education, and annual household incomes ranged from $36,250 to $46,249. Findings include the identification of fifteen themes through the process of thematic analysis that are organized by five thematic areas of interest (family food patterns, strategies for healthy eating, family roles in food shopping and preparation, family mealtimes, physical activity among families). Findings revealed ways fathers contributed to their children's and families' health and well-being, and challenges they faced. Health promotion efforts aimed at rural, low-income Mexican immigrant families can benefit from embracing fathers' perspectives and how they influence the health and well-being of their children and families.

The complexities of family mealtimes in the 21st century: A latent profile analysis

The goal of the present study was to characterize more than 500 families regarding family mealtime organization patterns. Family profiles were developed based on patterns detected across a set of sociological and psychological variables. Latent profile analyses indicated three distinct subgroups of families: Food Secure and Organized (55% of the sample), Very Low Food Security and Disorganized (27%), and Low Food Security and Organized (18%). Examination of group membership correlates revealed significant differences related to family mealtime behaviors and food preparation strategies, but not food shopping location or areas of requested change around family mealtimes. Findings highlight homogenous subgroups of families on the basis of co-occurring psychological and sociological factors pertinent to family mealtimes, with those families possessing the highest levels of risk in multiple domains also reporting family mealtime organization patterns associated with less healthy eating. Findings provide a snapshot into the organization, and complexities, of family meals for the American family today, highlighting the need for researchers and practitioners interested in promoting healthy food intake within American families to consider both psychological and sociological factors that influence family mealtime organization.

The Evolving Family Mealtime: Findings From Focus Group Interviews With Hispanic Mothers

BACKGROUND

Given the protective effects of shared family mealtimes and the importance of family in the Hispanic culture, this context should be explored further to determine how it can be leveraged and optimized for interventions.

OBJECTIVE

This study aimed to explore contextual factors associated with family mealtimes in Mexican and Puerto Rican families.

METHODS

A total of 63 mothers participated in 13 focus group interviews across 4 states. Thematic analysis was used to analyze transcripts.

RESULTS

Seven overarching themes were identified through the thematic analysis. Themes reflected who was present at the mealtime, what occurs during mealtime, the presence of television, the influence of technology during mealtime, and how mealtimes have changed since the mothers were children.

CONCLUSIONS

Hispanic mothers may be adapting family mealtimes to fit their current situations and needs, keeping the television and other devices on during mealtimes, and making additional meals for multiple family members to appease everyone's tastes. All of these are areas that can be incorporated into existing culturally tailored obesity prevention programs to help families lead healthier lives.

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

PURPOSE

This study examined how fathers and mothers coparent around child feeding.

METHODS

Father-mother pairs (N = 30) of preschool-aged children (M child age = 4.1 years old) participated in joint or group interview sessions.

RESULTS

Three themes emerged from the qualitative analysis: (1) couples' division of labor regarding feeding tasks seemed to align with stereotypical gender roles; (2) couples noted that they attempted healthier family eating habits in comparison to families of origin and recognized the influence of extended family on their attempts at healthier feeding; (3) couples agreed on the importance of family mealtime, routines, and healthy meals, yet disagreed on strategies to limit unhealthy foods and achieve harmonious family meals.

CONCLUSIONS

This study identified processes of coparenting and child feeding areas that were particularly challenging to manage among parents, which could be important targets for childhood obesity interventions.

LEVEL OF EVIDENCE

V, descriptive study.

Household Chaos, Maternal Emotional Responsiveness, and Child Eating Behavior: A Moderation Analysis

OBJECTIVE

To address calls for a resilience-informed approach to understand the cause and prevention of childhood obesity, the current study aims to investigate the independent and interactive associations between household chaos, maternal emotional responsiveness, and eating behavior in early childhood.

METHOD

A sample of (n = 108) families of 18- to 24-month-olds completed self-report surveys and consented to home visits as part of the larger STRONG Kids 2 (N = 468) study. Videotapes of family mealtimes were collected during home visits and coded for observed maternal emotional responsiveness. Mothers completed questionnaires assessing maternal emotional responsiveness, household chaos, and child eating behaviors. Moderation analyses assessed independent and interactive effects of chaos and emotional responsiveness on child appetite self-regulation.

RESULTS

In moderation analyses controlling for demographic covariates, higher levels of chaos were associated with more emotional overeating and with more food responsiveness, but only among children of mothers observed engaging in low levels of responsiveness at mealtimes. There was no association between chaos and eating behavior among children of mothers observed engaging in high levels of emotional responsiveness at mealtimes. There was also no independent or interactive association between chaos and child eating behaviors characterized by food avoidance.

CONCLUSION

Preliminary evidence suggests that maternal emotional responsiveness at mealtimes may attenuate the deleterious effects of chaos on child overeating and food responsiveness. Future research should prioritize using longitudinal designs, developing observational assessments of early childhood eating behaviors, and understanding these processes among families exposed to greater socioeconomic adversity.