Parental feeding practices as a response to child appetitive traits in toddlerhood and early childhood: a discordant twin analysis of the Gemini cohort

Abstract

Background Parental feeding practices (PFPs) have been implicated in the development of children’s eating behaviours. However, evidence suggests that feeding practices may also develop in response to their child’s weight or emerging appetitive traits. We used the twin design to test the hypothesis that parents develop their feeding practices partly in response to their child’s appetite. Methods Data were from Gemini, a population-based cohort of 2402 British families with twins born in 2007. Psychometric measures of PFPs and appetite were completed by parents when their twins were 16-months and 5-years. Within-family analyses including all twins with available data in the sample (n = 1010–1858 pairs), examined if within-pair differences in PFPs were associated with differences in appetitive traits, controlling for differences in birth weight-SDS, early feeding method and child sex. In a subsample of twin pairs who were considerably discordant for appetitive traits by ≥ 1SD (n = 122–544 pairs), the direction and magnitude of within-pair differences in feeding practices was explored. Results Within-family variation in parental feeding practices in toddlerhood and early childhood was low (discordance ranged from 0.1 to 6% of the sample), except for pressure to eat (toddlerhood: 19%; early childhood: 32%). Within-pair differences in all appetitive traits were associated with differential use of ‘pressure to eat’ at both 16-months and 5-years. In the subsample of twins most discordant for appetitive traits, parents used more pressure with the twin expressing lower food responsiveness, lower emotional overeating, lower food enjoyment, higher satiety responsiveness, slower speed of eating, higher emotional undereating and greater fussiness in toddlerhood and early childhood (p-values < 0.001). Effect sizes were small to large at 16-months (η2=0.02–0.09) and 5-years (η2=0.05–0.21). Conclusion Parents rarely varied their feeding practices between twins in toddlerhood and early childhood, except for pressure. Parents exerted greater pressure on their twin who expressed a poorer appetite compared to their co-twin, suggesting that parents develop a pressuring feeding style when their child expresses a poorer appetite or lower interest in, and enthusiasm for, eating. These findings could be used to guide interventions seeking to support parents in feeding their children in a way that nurtures the development of healthy eating behaviours.

Identifying an avid eating profile in childhood: associations with temperament, feeding practices and food insecurity

“…While this study reports associations between environmental variables and eating profiles, it is not possible to determine the cause of eating profiles or the impact of profiles on feeding practices. However, recent work does offer theoretical support of the causality and directionality of our included individual variables (see Kininmonth et al, 2023bKininmonth et al, , 2023c. Bidirectional relations were established between preschool children's food approach traits (namely emotional overeating) and nonresponsive feeding practices (i.e., instrumental feeding) (Kininmonth et al, 2023c).…”

“…However, recent work does offer theoretical support of the causality and directionality of our included individual variables (see Kininmonth et al, 2023bKininmonth et al, , 2023c. Bidirectional relations were established between preschool children's food approach traits (namely emotional overeating) and nonresponsive feeding practices (i.e., instrumental feeding) (Kininmonth et al, 2023c).…”

Relationship between energy balance and reward system gene polymorphisms and appetitive traits in young Mexican subjects

“…On the other hand, “Food fussiness” is a “food avoidance” trait, that refers to the reluctance to eat both new and familiar foods, pickiness of the flavor and texture of foods, and it has been mostly explored among children ( 51 , 52 ). Interestingly, although not significant, in this study, we found a tendency toward the presence of the COMT high-risk genotype MetMet+MetVal and higher “Food fussiness” ( r = 0.216, p = 0.066), and the protective genotype DRD2 A2A2 with lower “Food fussiness” ( r = −0.235, p = 0.60).…”

Helping parents to cope with infant regulatory disorders

“…• Eating something from each of the main food groups on most days (vegetables or fruit; potatoes, pasta, bread or rice; meat, fish or pulses; milk, cheese or yoghurt) • Gaining weight as expected (i.e., following their weight centile) • Active and healthy However, many parents find feeding problems to be stressful and there is clinical and epidemiological evidence that parents who feel anxious about their infant's food or milk intake may adopt controlling (e.g., pressuring or force-feeding) or indulgent feeding practices (e.g., cajoling or making a different meal), which can prolong or exacerbate feeding problems (6,9,64). Instead, responsive feeding-responding appropriately, quickly, and sensitively to an infant's feeding cues-is considered by professional organisations worldwide to be the optimum approach for parents to follow to support infants in developing healthy feeding behaviours.…”

“…Because our focus is on parents, it is worth saying at the outset that we do not intend to imply that parents cause infant RDs. There is ample evidence that all three RDs are associated with parental factors, such as anxiety, depression, and parenting behaviours, particularly in clinical samples (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). However, these are observational studies, which leave the direction of causation unclear.…”