Maternal feeding practices and fussy eating in toddlerhood: a discordant twin analysis

Abstract

BackgroundParental feeding practices are thought to play a causal role in shaping a child’s fussiness; however, a child-responsive model suggests that feeding practices may develop in response to a child’s emerging appetitive characteristics. We used a novel twin study design to test the hypothesis that mothers vary their feeding practices for twin children who differ in their ‘food fussiness’, in support of a child-responsive model.MethodsParticipants were mothers and their 16 month old twin children (n = 2026) from Gemini, a British twin birth cohort of children born in 2007. Standardized psychometric measures of maternal ‘pressure to eat’, ‘restriction’ and ‘instrumental feeding’, as well as child ‘food fussiness’, were completed by mothers. Within-family analyses examined if twin-pair differences in ‘food fussiness’ were associated with differences in feeding practices using linear regression models. In a subset of twins (n = 247 pairs) who were the most discordant (highest quartile) on ‘food fussiness’ (difference score ≥ .50), Paired Samples T-test were used to explore the magnitude of differences in feeding practices between twins. Between-family analyses used Complex Samples General Linear Models to examine associations between feeding practices and ‘food fussiness’.ResultsWithin-pair differences in ‘food fussiness’ were associated with differential ‘pressure to eat’ and ‘instrumental feeding’ (ps < .001), but not with ‘restriction’. In the subset of twins most discordant on ‘food fussiness’, mothers used more pressure (p < .001) and food rewards (p < .05) with the fussier twin. Between-family analyses indicated that ‘pressure to eat’ and ‘instrumental feeding’ were positively associated with ‘food fussiness’, while ‘restriction’ was negatively associated with ‘food fussiness’ (ps < .001).ConclusionsMothers appear to subtly adjust their feeding practices according to their perceptions of their toddler’s emerging fussy eating behavior. Specifically, the fussier toddler is pressured more than their less fussy co-twin, and is more likely to be offered food rewards. Guiding parents on how to respond to fussy eating may be an important aspect of promoting feeding practices that encourage food acceptance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0408-4) contains supplementary material, which is available to authorized users.

Prospects for early childhood feeding interventions: An exploration of parent's concerns and acceptability towards social media intervention opportunities

“…While there is no consensus on the definition of ‘fussy’ eating, which makes it difficult to ascertain prevalence, parents’ perceptions of fussiness, as measured in the present study, are equally important . That is, perceptions of ‘fussiness’ are understood to result in alterations in parents–child feeding interactions, such that parents are more inclined to use non‐responsive feeding practices which in turn have been seen to increase fussy behaviours . Given this, parents who simply perceive child feeding difficulties, are likely to benefit from child feeding interventions which focus on use of responsive feeding strategies.…”

“…21,22 That is, perceptions of 'fussiness' are understood to result in alterations in parents-child feeding interactions, such that parents are more inclined to use non-responsive feeding practices which in turn have been seen to increase fussy behaviours. 23,24 Given this, parents who simply perceive child feeding difficulties, are likely to benefit from child feeding interventions which focus on use of responsive feeding strategies.…”

Evidence for gene-environment correlation in child feeding: Links between common genetic variation for BMI in children and parental feeding practices

“…A reverse relationship also pertained, but the temporal association from child to parent was stronger. A large within-family study of preschool twins showed that parents varied their pressuring feeding style when their twins were discordant for food fussiness 29 . The fussier twin was pressured more than their co-twin, also in support of a child-driven model of parental feeding behaviour.…”

The Montreal Children’s Hospital Feeding Scale: Relationships with parental report of child eating behaviours and observed feeding interactions

“…In addition to significant genetic underpinnings, there are also strong environmental determinants of feeding problems or fussy eating, particularly the feeding practices (Harris et al, 2016) that parents use. Much research has established the importance of early feeding behaviour and a high quality…”

“…Practices such as restriction and pressure to eat can have unintended negative consequences for children's eating (Birch, Fisher, & Davison, 2003;Galloway, Fiorito, Francis, & Birch, 2006;Ogden, Cordey, Cutler, & Thomas, 2013) whereas practices such as monitoring of child food intake can have positive outcomes such as reduced non-nutritive food choices (Klesges, Stein, Eck, Isbell, & Klesges, 1991;Musher-Eizenman & Holub, 2007). It is also important to note that several studies have found parental feeding practices to be the result of child characteristics and behaviours, rather than the cause, or have found bidirectional relationships in feeding interactions (Demir et al, 2012;Harris et al, 2016;Hodges et al, 2013). Therefore, it is important to examine the relationship between the MCHFS and parental report of feeding practices early in life, when complementary feeding is becoming established.…”