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Chilman LB, Meredith PJ, Southon N, Kennedy-Behr A, Frakking T, Swanepoel L, Verdonck M. A qualitative inquiry of parents of extremely picky eaters: Experiences, strategies and future directions. Appetite 2023; 190:107022. [PMID: 37647989 DOI: 10.1016/j.appet.2023.107022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND/AIM Picky eating is a common childhood phenomenon in younger children, impacting family relationships and mealtimes. Limited qualitative studies have explored parents' experiences of parenting an extremely picky eater. This study aimed to address this gap. METHODS This exploratory qualitative research design included participants who were Australian-based parents (n = 10) of children aged 2-6 years with a minimum picky eating score of 3.33, indicating extreme picky eating, on the Food Fussiness subscale of the Child Eating Behavior Questionnaire (CEBQ). Parents were interviewed online via Zoom using semi-structured interviews focused on their experiences of having a child who is a picky eater. Reflexive thematic analysis was used to analyze the data. RESULTS Five themes were identified: 1: The picky eating journey for parents. 2: Picky eating impacts families and mealtimes. 3: Parents have attempted multiple strategies to manage picky eating. 4: Emotions associated with parenting an extremely picky eater. 5: Parents of extremely picky eaters have a positive outlook for the future. CONCLUSION This qualitative study demonstrates that parents' experiences of parenting an extremely picky eater are varied. Parents desire health professionals who listen to their concerns and provide evidence-based knowledge around parent feeding practices to positively impact picky eating.
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Affiliation(s)
- Laine B Chilman
- School of Health, University of the Sunshine Coast, 4558, Australia.
| | - Pamela J Meredith
- School of Health, University of the Sunshine Coast, 4558, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, 4072, Australia
| | - Nicole Southon
- School of Health, University of the Sunshine Coast, 4558, Australia
| | - Ann Kennedy-Behr
- School of Health, University of the Sunshine Coast, 4558, Australia; School of Allied Health & Human Performance, University of South Australia, 5072, Australia
| | - Thuy Frakking
- School of Health, University of the Sunshine Coast, 4558, Australia; Research Development Unit, Caboolture Hospital, Metro North Hospital and Health Service, Queensland Health, 4029, Australia; Centre for Clinical Research, School of Medicine, The University of Queensland, Queensland, 4072, Australia; Speech Pathology Department, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, 4215, Australia
| | - Libby Swanepoel
- School of Health, University of the Sunshine Coast, 4558, Australia; Australian Centre for Pacific Islands Research, School of Health, University of the Sunshine Coast, Queensland, 4558, Australia
| | - Michèle Verdonck
- School of Health, University of the Sunshine Coast, 4558, Australia
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‘Fussy eating’ and feeding dynamics: School children's perceptions, experiences, and strategies. Appetite 2022; 173:106000. [DOI: 10.1016/j.appet.2022.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/30/2022] [Accepted: 03/04/2022] [Indexed: 11/02/2022]
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Kim YK, Di Martino JM, Nicholas J, Rivera-Cancel A, Wildes JE, Marcus MD, Sapiro G, Zucker N. Parent strategies for expanding food variety: Reflections of 19,239 adults with symptoms of Avoidant/Restrictive Food Intake Disorder. Int J Eat Disord 2022; 55:108-119. [PMID: 34761436 PMCID: PMC8841112 DOI: 10.1002/eat.23639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To characterize helpful parent feeding strategies using reflections on childhood eating experiences of adults with symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID). METHOD We explored a unique text-based dataset gathered from a population of N = 19,239 self-identified adult "picky eaters." The sample included adults with symptoms of ARFID as evidenced by marked interference in psychosocial functioning, weight loss/sustained low weight, and/or nutritional deficiency (likely ARFID), and non-ARFID participants. We leveraged state-of-the-art natural language processing (NLP) methods to classify feeding strategies that were perceived as helpful or not helpful. The best classifiers that distinguished helpful approaches were further analyzed using qualitative coding according to a grounded theory approach. RESULTS NLP reliably and accurately classified the perceived helpfulness of caregivers' feeding strategies (82%) and provided information about features of helpful parent strategies using recollections of adults with varying degrees of food avoidance. Strategies perceived as forceful were regarded as not helpful. Positive and encouraging strategies were perceived as helpful in improving attitudes toward food and minimizing social discomfort around eating. Although food variety improved, adults still struggled with a degree of avoidance/restriction. DISCUSSION Adults perceived that positive parent feeding strategies were helpful even though they continued to experience some degree of food avoidance. Creating a positive emotional context surrounding food and eating with others may help to eliminate psychosocial impairment and increase food approach in those with severe food avoidance. Nevertheless, additional tools to optimize parent strategies and improve individuals' capacity to incorporate avoided foods and cope with challenging eating situations are needed.
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Affiliation(s)
| | | | - Julia Nicholas
- Psychiatry and Behavioral Sciences, Duke University, USA
| | | | | | | | - Guillermo Sapiro
- Electrical and Computer Engineering, Duke University, USA,Computer Sciences, Duke University, USA,Biomedical Engineering, Duke University, USA,Mathematics, Duke University, USA
| | - Nancy Zucker
- Psychiatry and Behavioral Sciences, Duke University, USA,Psychology and Neuroscience, Duke University, USA
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Fraser K, Markides BR, Barrett N, Laws R. Fussy eating in toddlers: A content analysis of parents' online support seeking. MATERNAL & CHILD NUTRITION 2021; 17:e13171. [PMID: 33739624 PMCID: PMC8189205 DOI: 10.1111/mcn.13171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 01/02/2023]
Abstract
The development of healthy eating habits in childhood is essential to reducing later risk of obesity. However, many parents manage fussy eating in toddlerhood with ineffective feeding practices that limit children's dietary variety and reinforce obesogenic eating behaviours. Understanding parents' feeding concerns and support needs may assist in the development of feeding interventions designed to support parents' uptake of responsive feeding practices. A total of 130 original posts by parents of toddlers (12-36 months) were extracted from the online website Reddit's 'r/Toddlers' community discussion forum over a 12-month period. Qualitative content analysis was used to categorise the fussy eating topics that parents were most concerned about and the types of support they were seeking from online peers. The most frequently raised fussy eating concerns were refusal to eat foods offered, inadequate intake (quantity and quality), problematic mealtime behaviours and changes in eating patterns. Parents were primarily seeking practical support (69.2%) to manage emergent fussy eating behaviours. This consisted of requests for practical feeding advice and strategies or meal ideas. Nearly half of parents sought emotional support (47.7%) to normalise their child's eating behaviour and seek reassurance from people with lived experience. Informational support about feeding was sought to a lesser extent (16.2%). Fussy eating poses a barrier to children's dietary variety and establishing healthy eating habits. These results suggest parents require greater knowledge and skills on 'how to feed' children and support to manage feeding expectations. Health professionals and child feeding interventions should focus on providing parents with practical feeding strategies to manage fussy eating. Supporting parents to adopt and maintain responsive feeding practices is vital to developing healthy eating habits during toddlerhood that will continue throughout adulthood.
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Affiliation(s)
- Kylie Fraser
- School of Health and Social DevelopmentDeakin UniversityVictoriaAustralia
| | - Brittany Reese Markides
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityVictoriaAustralia
| | - Norma Barrett
- School of Health and Social DevelopmentDeakin UniversityVictoriaAustralia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityVictoriaAustralia
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5
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Iwinski S, Cole NC, Saltzman JA, Donovan SM, Lee SY, Fiese BH, Bost KK. Child attachment behavior as a moderator of the relation between feeding responsiveness and picky eating behavior. Eat Behav 2021; 40:101465. [PMID: 33310487 PMCID: PMC10796209 DOI: 10.1016/j.eatbeh.2020.101465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/21/2020] [Accepted: 11/22/2020] [Indexed: 02/02/2023]
Abstract
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.
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Affiliation(s)
- Samantha Iwinski
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America.
| | - Natasha Chong Cole
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America
| | - Jaclyn A Saltzman
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America; The MITRE Corporation, Bedford, MA, United States of America
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America; Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States of America
| | - Soo-Yeun Lee
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America; Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States of America
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America
| | - Kelly K Bost
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America
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Wolstenholme H, Kelly C, Hennessy M, Heary C. Childhood fussy/picky eating behaviours: a systematic review and synthesis of qualitative studies. Int J Behav Nutr Phys Act 2020; 17:2. [PMID: 31900163 PMCID: PMC6942299 DOI: 10.1186/s12966-019-0899-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 12/10/2019] [Indexed: 12/21/2022] Open
Abstract
Fussy/picky eating behaviours are common across childhood. Recent reviews of the fussy eating literature focus on quantitative research and do not adequately account for families' subjective experiences, perceptions and practices. This review aims to synthesise the increasing volume of qualitative work on fussy eating. A systematic search of relevant databases was carried out. Studies were included if they were qualitative, published since 2008, with a primary focus on families' experiences, perceptions and practices regarding fussy eating, food neophobia, or food refusal in children (aged one to young adult). Studies with clinical samples, or relating to children under one year were excluded. Ten studies were eligible for this review and were synthesised using meta-ethnography (developed by Noblit and Hare). This review provides a comprehensive description and definition of fussy eating behaviours. A conceptual model of the family experience of fussy eating was developed, illustrating relationships between child characteristics (including fussy eating behaviours), parent feeding beliefs, parent feeding practices, mealtime emotions and parent awareness of food preference development. Our synthesis identified two ways in which fussy eating relates to mealtime emotions (directly and via parent feeding practices) and three distinct categories of parent beliefs that relate to fussy eating (self-efficacy, attributions and beliefs about hunger regulation). The model proposes pathways which could be explored further in future qualitative and quantitative studies, and suggests that parent beliefs, emotions, and awareness should be targeted alongside parent feeding practices to increase effectiveness of interventions. The majority of studies included in this review focus on pre-school children and all report the parent perspective. Further research is required to understand the child's perspective, and experiences of fussy eating in later childhood. PROSPERO Registration: CRD42017055943.
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Affiliation(s)
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland
| | - Marita Hennessy
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland, Galway, Ireland
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Bekelman TA, Bellows LL, Clark L, Thompson DA, Kemper G, McCloskey ML, Johnson SL. An Ecocultural Perspective on Eating-Related Routines Among Low-Income Families With Preschool-Aged Children. QUALITATIVE HEALTH RESEARCH 2019; 29:1345-1357. [PMID: 30499371 PMCID: PMC6538438 DOI: 10.1177/1049732318814540] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Eating-related routines, such as regular mealtimes, can protect against obesity. Little is known about eating-related routines among preschoolers or the factors that shape those routines. Ecocultural Theory and qualitative interviews with 30 caregivers of preschoolers in Colorado were used to describe eating-related routines at home and parents' perspectives on the factors that shape routines. Qualitative content analysis was used to analyze and interpret data. Consistent with clinical recommendations, parents' goals included dinner meals where adults and preschoolers eat the same food, in the same place, at the same time. However, parents' employment schedules and challenges in managing preschoolers' behavior prevented parents from consistently enacting recommended routines. Educating parents alone may not be sufficient to ensure optimal eating-related routines among preschoolers, and the household context needs to be considered. Families organized routines according to cultural values and available resources.
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Affiliation(s)
- Traci A Bekelman
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Lauren Clark
- 3 The University of Utah, Salt Lake City, Utah, USA
| | - Darcy A Thompson
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Geri Kemper
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Susan L Johnson
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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