Background Bottle-fed infants are at greater risk for overfeeding and rapid weight gain (RWG); evidence-based strategies for promoting healthy bottle-feeding practices are needed.Objective Our aim was to assess whether policy, systems, and environmental (PSE) strategies for promoting responsive bottle-feeding practices within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were associated with lower risk for RWG.Design We conducted a matched-pair cluster randomized trial. PSE strategies were implemented at 3 WIC clinics in Los Angeles County. PSE clinics were compared with 3 matched control clinics. Mothers and infants were assessed when infants were newborn and 3 months and 6 months of age.Participants/setting Participants were mothers (n ¼ 246) who enrolled their newborn infants (younger than 60 days) into WIC between May and August 2019.Main outcome measures Infant weight was assessed and standardized to sex-and age-specific z scores. RWG was defined as weight-for-age z score change > 0.67. Mothers completed questionnaires assessing responsive and pressuring feeding styles, breastand bottle-feeding patterns, and perceptions of WIC experiences. Statistical analyses performed Logistic regression with estimation via generalizedestimating equations and linear mixed models with repeated measures assessed effects of PSE strategies on categorical and continuous outcomes, respectively.Results Infants in PSE clinics had significantly lower likelihood of exhibiting RWG (P ¼ .014) than infants in control clinics. Mothers in PSE and control clinics reported similar levels of responsive and pressuring feeding style and similar prevalence of breastfeeding and bottle-feeding. Mothers in PSE clinics trended toward feeling better supported with respect to their decision to bottle-feed (P ¼ .098) and had more stable intentions to stay in the WIC program (P ¼ .002) compared with mothers in control clinics.Conclusions PSE strategies focused on promoting more inclusive assessment of infant feeding, tailored bottle-feeding counseling, and increased education and support for responsive bottle-feeding were associated with lower risk for RWG among WIC infants.

The current study examined the relationships between the specific strategies that preschool children use to regulate their emotions and childhood weight status to see if emotion regulation strategies would predict childhood weight status over and above measures of eating self-regulation. 185 4- to 5-year-old Latino children were recruited through Head Start centers in a large city in the southeastern U.S. Children completed both a delay of gratification task (emotion regulation) and an eating in the absence of hunger task (eating regulation). Eating regulation also was assessed by maternal reports. Four emotion regulation strategies were examined in the delay of gratification task: shut out stimuli, prevent movement, distraction, and attention to reward. Hierarchical linear regressions predicting children’s weight status showed that both measures of eating regulation negatively predicted child obesity, and the use of prevent movement negatively predicted child obesity. Total wait time during the delay of gratification tasks was not a significant predictor. The current findings are consistent with studies showing that for preschool children, summary measures of emotion regulation (e.g., wait time) are not concurrently associated with child obesity. In contrast, the use of emotion regulation strategies was a significant predictor of lower child weight status. These findings help identify emotion regulation strategies that prevention programs can target for helping children regulate their emotions and decrease their obesity risk.

Parents influence child weight through interactions that shape the development of child eating behaviors. In this study we examined the association between maternal autonomy promoting serving practices and child appetite regulation. We predicted that maternal autonomy promoting serving practices would be positively associated with child appetite regulation. Participants were low-income Latino children—a group at high risk for the development of childhood obesity. A total of 186 low-income Latina mothers and their 4-5 year old children came to a laboratory on two separate days. On the first day, mothers and children chose foods for a meal from a buffet and were audio/videotaped so that maternal autonomy promoting serving practices could be later coded. On the second day, children completed the Eating in the Absence of Hunger (EAH) task to measure child appetite regulation. Mothers also completed the Child Eating Behavior Questionnaire (CEBQ) to measure other aspects of child appetite regulation (food responsiveness, satiety responsiveness, and emotional overeating). Maternal autonomy promotion during serving was assessed using seven separate measures of child and maternal behavior. Principal components analyses of these serving measures yielded three components: allows child choice, child serves food, and mother does not restrict. Consistent with hypotheses, maternal autonomy promoting serving practices (i.e., allows child choice and does not restrict) were negatively associated with maternal reports of child food responsiveness and emotional overeating (CEBQ). The results for the EAH task were more complex—mothers who were autonomy promoting in their serving practices had children who ate the most in the absence of hunger, but this linear effect was moderated somewhat by quadratic effect, with moderate levels of autonomy promotion during serving associated with the greatest child EAH.

The current results indicate that for research purposes the variable-centered approach may be the most powerful for examining relationships between maternal feeding and child eating. However, for clinical purposes, the person-centered approach might be most informative.

BackgroundDuring the last two decades, researchers have devoted considerable attention to the role of maternal feeding behaviors, practices, and styles in the development of obesity in young children. Little is known, however, about the consistency of maternal feeding across settings and time. The purpose of this paper was to provide data on this issue by examining the consistency of observed maternal feeding behavior across multiple eating occasions, as well as examine the consistency of observed and self-reported maternal feeding behavior across 18 months.MethodsVideotapes from two studies of low-income mothers and their preschool children were coded for feeding practices, dimensions, and styles: a study of 137 low-income, African American and Latina mothers and their children observed during three meals in their homes over a two to three week period, and a study of 138 low-income, Latina mothers observed during a buffet meal in a laboratory setting on two separate occasions 18 months apart. Videotapes from both studies were coded for a wide range of maternal feeding behaviors and strategies. Mothers in the second study also completed three validated, self-report questionnaires on their feeding practices and styles.ResultsOverall, both observed and self-reported feeding practices and styles showed only moderate levels of stability across meals and over time. Maternal attempts to regulate children’s eating showed more stability across meals and over time than the content of general mealtime conversation. Also, greater stability was found in what mothers were trying to get their children to do during the meals than in the strategies they used to influence child behavior. Self-reports of feeding showed greater stability over time than observational measures. Across meals and across 18 months, the stability of general feeding styles was between 40% and 50%.ConclusionsThe findings demonstrate that maternal feeding behavior was only moderately stable across meals and over time—that is, feeding behavior varied considerably across situations. The lack of high levels of consistency in feeding behavior suggests that situational factors may play a major role in influencing maternal behavior as well. Family-focused childhood obesity programs should focus not only on helping parents change their feeding practices and styles, but also focus on increasing parents’ sensitivity to situational factors that affect their approach to feeding their children.

No abstract

Evidence‐based policy making often has a direct or indirect goal of promoting family resilience. The authors consider the ways in which scholarly disagreements about evidence can challenge this goal, focusing on the debate regarding whether adult–infant bedsharing increases the risk of infant mortality. A central issue is whether scholars conclude that public policy should recommend against all bedsharing or only bedsharing in particular risky circumstances. The authors use context‐based evidence‐based policy making (Dobrow, Goel & Upshur, 2004) as a framework for a review of studies of sudden infant death syndrome (SIDS) correlates and SIDS mechanisms related to bedsharing as well as the reasons parents bed share. The authors discuss the implications of different interpretations of the evidence and point to the potential of adversarial collaboration in helping to address the points of disagreement and ultimately better support family resilience. The issues discussed in this case are broadly relevant to other debated evidence for family policy making.

No abstract