Prevalence of Feeding Problems in Children and Associated Factors-A Cross-Sectional Study among Polish Children Aged 2-7 Years

Complementary Feeding Methods, Feeding Problems, Food Neophobia, and Picky Eating among Polish Children

Proper nutrition during the first period of life is primarily related to meeting energy needs and providing essential nutrients that ensure the infant's normal physical and psychomotor development. Improper nutrition during this period, inadequate amounts of nutrients, inappropriate timing and manner of introduction of individual foods, can permanently alter metabolism and the course of physiological processes, increasing the risk of diseases such as obesity, allergic diseases, and cardiovascular diseases. This study aimed to verify how the method of complementary feeding influences the occurrence of food neophobia between 2 and 7 years of age, as well as to assess the different nutritional aspects resulting from the process of starting feeding other than breast milk and milk formula. In this study, 490 mothers and their children aged 2-7 years participated. The research tool was a questionnaire consisting of a child's dietary assessment and standardized questionnaires assessing food neophobia among children: Food Neophobia Scale for Children (FNSC) and the Montreal Children's Hospital-Pediatric Feeding (MCH-FS). In the study group of children, 238 (48.57%) had no Baby-Led Weaning Method (no BLW) method used during complementary feeding (CF), and 252 (51.42%) children used Baby-Led Weaning Method (BLW). According to the FNSC questionnaire, a high risk of food neophobia was found in 32.65% of the children studied and a medium risk in 39.80%. The medium risk of feeding problem occured in 11.63% of children, the high risk in 6.73% of children, and the highest risk in 6.94% (MCH-FS). No statistically significant differences were observed between the BLW and NoBLW groups. High risk of food neophobia occured in 1/3 of the children studied, but there was no relationship in the study group between the mode of CF (BLW/NoBLW) and the risk of food neophobia.

Adherence to Mediterranean Diet and Food Neophobia Occurrence in Children: A Study Carried out in Italy

Food Neophobia (FN), defined as the reluctance to eat new or unfamiliar foods, mainly concerns fruit, vegetables, and legumes, typical of the Mediterranean Diet (MD). Considering these premises, this study aimed to clarify the relationship between FN and AMD in a sample of Italian children and their association with some socio-demographic factors and children's nutritional status. A sample of 288 children aged 3-11 years participated in an assessment carried out with a questionnaire evaluating FN and AMD, respectively, with the Child Food Neophobia Scale (CFNS) and the KIDMED test. Most of the sample showed an intermediate (67.3%) or high level of FN (18.1%), with high rates among 6-11-year-old children (63.9%) and especially in those who were the only child (50%). The AMD was mostly low (29.5%) or medium (54.8%) and reached lower levels among higher neophobic children (51.9%; p value < 0.05). The present results confirm the study hypothesis that FN is a driver of MD abandonment and shows the positive effects on children's eating habits and siblings. Finally, this study proves the relevance of adopting effective feeding strategies against FN to avoid its maintenance in adulthood and the detrimental effects on future overall health and well-being.

How parents' feeding styles, attitudes, and multifactorial aspects are associated with feeding difficulties in children

BACKGROUND

Parental complaints about feeding difficulties (FD) during childhood are frequent in pediatrics. Behavioral factors about children's feeding and parental aspects are fundamental in solving these problems, but research in this area lacks information considering the joint presence of fathers and mothers. Thus, this study aimed to investigate the features of children, parents and mealtime practices related to FD reported by fathers and mothers and to identify parenting styles, mealtime actions, practices and factors associated with FD in children.

METHODS

323 parents (226 mothers and 97 fathers) of children aged 1 to 7 years were recruited in the emergency waiting room at Sabará Hospital Infantil, in São Paulo, Brazil, and self-completed electronic questionnaires on parenting style (Caregiver's Feeding Styles Questionnaire), parents' mealtime actions (Parent Mealtime Action Scale), socioeconomic information, personal and children's health data and routine meal practices.

RESULTS

The prevalence of FD in children was 26.6%. Indulgent parenting style was the most frequent (44.2%), followed by authoritarian (25.1%), authoritative (23.8%), and uninvolved (6.9%) styles. Most parents (75.8%) reported presence during meals, and 83.6% used distractions. Regression analyses after adjustments showed, as factors associated with FD, female children (OR: 2.06; 95%CI: 1.19-3.58), parents' FD history (OR: 3.16; 95%CI: 1.77-5.64), and greater frequency of parents' behavior of offering many food options (OR: 2.69; 95%CI: 1.18-6.14). Parents with indulgent styles had decreased chances of reporting FD in their children (OR: 0.13; 95%CI: 0.06-0.27). Furthermore, the practice of children sharing the family menu (OR: 0.43; 95%CI: 0.18-0.99) and higher frequency of parents' behavior of setting snack limits (OR: 0.44; 95%CI: 0.23-0.85) were inversely associated with FD.

CONCLUSIONS

This study reinforces the multifactorial aspects involved in the feeding difficulties context. It points out the importance of expanding knowledge of the individual role of fathers and mothers to compose a scenario that can guide future studies and interventions.

TRIAL REGISTRATION

CAAE #99221318.1.0000.5567 with registration number 2,961,598.

Infant Complementary Feeding Methods and Subsequent Occurrence of Food Neophobia-A Cross-Sectional Study of Polish Children Aged 2-7 Years

Food neophobia is standard behaviour in child development. It is a complex process and occurs to varying degrees. The symptoms of neophobia can be variable depending on the individual. Food neophobia is a fear of new foods, whereby difficulties in eating and trying unfamiliar foods follow. It is one of the more vital determinants of the number of meals consumed at a young age. Such a process is not a disorder in itself but can lead to one. The highest severity of neophobia occurs between the ages of two and six, but in some children, it lasts beyond age 6. This study aimed to assess the prevalence of food neophobia among children aged 2-7 years, taking into account the method of complementary feeding, the length of breastfeeding, exclusive breastfeeding, the period of introduction of complementary foods, and the use of the BLW method during the period of dietary expansion.

MATERIALS AND METHODS

The study used an anonymous survey questionnaire consisting of five parts as the research tool. The first part of the questionnaire was a metric and concerned the socio-demographic data of the parent/guardian and their child. A standardised questionnaire assessing food neophobia among children was used to assess food neophobia: the Food Neophobia Scale-Children (FNSC).

RESULTS

In the study group, 171 children (29.23%) had a low risk of food neophobia according to the FNSC, 182 children (31.11%) had a medium risk of neophobia, and 232 children (39.66%) had a high risk of neophobia. A correlation was observed between the age and the risk of food neophobia (p = 0.0002). Statistically significant differences were found between children aged 2 and 4 (p = 0.003) and children aged 2 and 5 years (p = 0.049). We observed no correlation between gagging (p = 0.88557), choking (p = 0.17597), and needing medical intervention (p = 0.61427) and the risk of associated neophobia.

CONCLUSION

In the study group of children, the highest risk of food neophobia was characterized by children aged 4, 5, and 7 years. The length of breastfeeding and exclusive breastfeeding did not affect the risk of food neophobia. In the month in which complementary feeding (CF) was introduced, the children were fed using the baby-led weaning method (BLW method), and introducing puree and puree with lump food into the children's diet also did not affect the risk of food neophobia. It was shown, however, that children whose mothers observed difficulties during CF and whose children had a vomiting reflex and spat food out of their mouths during CF were more likely to develop food neophobia at the preschool age.