Caregiver feeding practices and child weight outcomes: a systematic review

Abstract

Background As part of the USDA–Department of Health and Human Services Pregnancy and Birth to 24 Months Project, we conducted systematic reviews (SRs) on topics important for health and nutrition of young children. Objectives The purpose of the present SR was to examine the relation between caregiver feeding practices in children from birth to 24 mo and child weight gain, size, and body composition. Methods A search of articles published from January 1980 to January 2017 in 4 databases identified 8739 references. Nutrition Evidence Systematic Review (NESR) analysts used the Nutrition Evidence Library Risk of Bias Assessment Tool to assess potential bias in the studies, and a Technical Expert Collaborative graded the body of evidence using the NESR grading rubric. Results Twenty-seven articles were included in this review (8 controlled trials, 19 longitudinal cohort studies). Moderate evidence from randomized controlled trials suggests that providing responsive feeding guidance to teach mothers to recognize and respond appropriately to children's hunger and satiety cues can lead to “normal” weight gain and/or “normal” weight status in children aged ≤2 y compared with children whose mothers did not receive responsive feeding guidance. Moderate evidence from longitudinal cohort studies indicates an association between maternal feeding practices and the child's weight status and/or weight gain, but the direction of effect has not been adequately studied. Restrictive feeding practices are associated with increased weight gain and higher weight status, and pressuring feeding practices are associated with decreased weight gain and lower weight status. Evidence suggests that a mother's feeding practices are related to concerns about her child's body weight. Conclusions This review highlights the importance of the interaction between caregivers and infants and toddlers related to child feeding practices on children's weight outcomes. Research is needed on more diverse populations with consistent methodological app-roaches and objective measures.

A measurement scale to assess responsive feeding among Cambodian young children

“…Moreover, between 30% and 42% of caregivers had a positive behaviour regarding self‐feeding. Although different context, in Ethiopia, a study investigating feeding practices among a group of child aged 12–23 months found that only 45% of them were eating in their own plate and verbally encouraged to self‐feed (Spill et al, ). The discrepancy between our results and Ethiopia data may be due to the fact that our population included younger children.…”

Consensus of the Brazilian Association of Nutrology on Milky Feeding of Children Aged 1–5 Years Old

“…On the other hand, restrictive and coercive practices are associated with excess and weight gain and nutritional deficits and low weight, respectively. 63 Even in cases of greater severity, the occurrence of eating difficulties in childhood does not determine anthropometric changes in most cases. However, the risk of nutritional problems and micronutrient deficiency results from the consumption of foods of high energy value, rich in fat and sugar, and of low nutritional value.…”

“…62 During the first years of life, family eating habits and biopsychosocial factors are particularly relevant in the genesis of nutritional problems and malnutrition. 63 The inclusion of all food groups in the main meals, the variety of the supply of fruits in natura, legumes and vegetables, and the restriction of the consumption of flavor enhancers, sugar and saturated fats, contribute to the establishment of preferences, choices and habits that confer health benefits. 64 The choices and behaviors that go to the family table directly reflect on the quality of the food of the child, who mirrors their parents.…”

“…Paradoxically, most inappropriate parental practices result from the concern of the parents about their children's weight. 63 Responsive or authoritative caregivers are those who sufficiently correspond to the child's demands, encouraging the exercise of their autonomy and valuing the signs of hunger and satiety to determine the beginning and end of the meal. On the other hand, authoritarian, indulgent or negligent caregivers, impair the normal development of the diet.…”

Associations between maternal and paternal feeding styles of infants in a racially diverse US birth cohort

“…Parenting behaviour, which includes feeding style, has been associated with child weight status 1,2 . The mechanism is likely complex, operating through both direct (eg, pressuring children to eat) and indirect (eg, parental dietary intake) pathways 1,3,4 .…”