Caregivers' feeding practices in Ethiopia: association with caregiver and child characteristics

Abstract

Feeding is a source of interaction and communication. It affects children's physical and psychological/emotional development. The present study aims to examine the association between caregiver and child characteristics and caregivers' feeding practices among preschools in Addis Ababa. We conducted a cross-sectional study among 542 caregivers of children aged between 3 and 6 years old in selected preschools. We used the Child Feeding Questionnaire (CFQ) to measure caregivers' feeding practices. Multiple linear regression was used for analysis. Caregivers who had higher levels of perceived feeding responsibility (β 0⋅20, P < 0⋅001), who were more concerned about their child being overweight (β 0⋅11, P < 0⋅001) and who had more depressive symptoms (β 0⋅23, P 0⋅05) were associated with food restriction practice. Caregivers who were less concerned about their child being overweight (β −0⋅10, P < 0⋅001) and who had higher levels of perceived feeding responsibility (β 0⋅25, P < 0⋅001) were associated with pressure to eat practice. Caregivers who had higher education (β 0⋅29, P < 0⋅05), who had higher levels of perceived feeding responsibility (β 0⋅47, P < 0⋅001), who were more concerned about their child being overweight (β 0⋅15, P < 0⋅001) and who were less concerned about their child underweight (β −0⋅06, P < 0⋅05) were associated with monitoring feeding practice. In addition, as the children have gotten older (β 0⋅08, P < 0⋅05), there is increased use of monitoring feeding practice. This study is one of few studies that show the association between caregiver and child characteristics and feeding practices in developing countries such as Ethiopia. It is essential to include responsive feeding components in national nutritional programmes to improve preschool children's nutritional status in Ethiopia.

The Relationships between Caregivers’ Concern about Child Weight and Their Non-Responsive Feeding Practices: A Systematic Review and Meta-Analysis

“…Characteristics of the included studies are shown in Table 1 . The studies were published between 2001 and 2022, conducted in the US ( n = 12) [ 21 , 24 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ], Australia ( n = 6) [ 26 , 27 , 75 , 76 , 77 , 78 ], Brazil ( n = 4) [ 28 , 30 , 50 , 79 ], Sweden ( n = 4) [ 22 , 80 , 81 , 82 ], China ( n = 2) [ 83 , 84 ], the Netherlands ( n = 1) [ 85 ], Ethiopia ( n = 1) [ 29 ], the UK ( n = 1) [ 86 ], Mexico ( n = 1) [ 87 ], South Korea ( n = 1) [ 88 ], Portugal ( n = 1) [ 23 ], India ( n = 1) [ 25 ], and France ( n = 1) [ 74 ]. The study designs were a cross-sectional study ( n = 32) and a cohort study ( n = 3) [ 23 , 26 , 85 ].…”

“…The caregivers were typically mothers ( n = 19). Only four studies used a random sampling method [ 27 , 29 , 67 , 83 ].…”

“…The most common measurement was CFQ [ 19 ], which was intended for parents of children aged 2–11 years. Thirty studies used the subscale of concern about child weight in CFQ to assess caregivers’ concern about children at risk of being overweight [ 19 ], and two studies [ 29 , 77 ] used the Preschooler Feeding Questionnaire (PFQ) [ 89 ] to assess caregivers’ concern about child underweight. CFQ ( n = 21) and the Chinese Child Feeding Questionnaire (C-CFQ) [ 90 ] ( n = 2) [ 83 , 84 ] was used to assess the domains of non-responsive feeding practices, including restriction, pressure to eat, and use of food as a reward.…”

“…In addition to the evidence above, some studies have suggested that caregivers’ concern about child underweight and overweight may have different effects on their non-responsive feeding practices [ 27 , 28 , 29 ]. For example, a cross-sectional study in Brazil ( n = 659) reported that parental concern about child overweight was associated with more food restriction for children’s weight control and health, while concern about child underweight was associated with more pressure to eat [ 28 ].…”

“…For example, a cross-sectional study in Brazil ( n = 659) reported that parental concern about child overweight was associated with more food restriction for children’s weight control and health, while concern about child underweight was associated with more pressure to eat [ 28 ]. Similarly, Gebru et.al [ 29 ] used a multi-stage random sampling method and found that caregivers who were concerned about child underweight were more likely to pressure their children to eat and might not restrict their children’s food, whereas caregivers who were concerned about child overweight were more likely to restrict their children’s food intake and less likely to force children to eat. Warkentin et.al [ 30 ] also found that parental higher concern about child overweight was associated with restrictive feeding, but not associated with practices such as forcing children to eat or using food as a reward after controlling for the confounders.…”