Purpose: Interventions that promote responsive feeding in early childhood have been shown to reduce risks of obesity. However, interventions mostly target parent-child dyads and do not consider the complexities of implementing responsive feeding across multiple children within a family unit. An understanding of how parents adapt their feeding practices and styles between siblings may enable family-based feeding interventions to be tailored more effectively. This scoping review therefore aims to assess the scope and nature of the current literature examining parent feeding practices and styles in the context of siblings.

Methods: This scoping review was conducted in accordance with Joanna Briggs Institute (JBI) methodological guidance. Six electronic databases were searched (APA PsycINFO, CINAHL, Embase, Medline, ProQuest Dissertations & Theses Global, and Scopus) for articles published up until 25 November 2021. Studies were included if they compared the use of parent feeding practices and/or styles for two or more siblings aged ≤18 years. Journal articles, theses, and dissertations were considered for inclusion with a focus on empirical data. For relevant studies, data were extracted and analysed using basic descriptive statistics. 

Results: A total of 18 studies (14 quantitative and 4 qualitative) met the eligibility criteria and were included in this review. Studies were undertaken in the United States (n=12) and Europe (n=6), with the majority (n=12) targeting school-aged children between 6 and 18 years of age. Most studies (n=11) tested differences in the use of parent-reported feeding practices between siblings, namely restriction and pressure to eat, in relation to differences in their characteristics, including weight status, eating behaviours, food consumption, temperaments, birth order, age, and sex.

Conclusions: Current research is reliant mostly on cross-sectional, parent-reported studies that were conducted in small, homogenous samples. The studies provide some evidence that parents may modify certain feeding practices or styles for siblings in response to differences in their characteristics. Future research should explore the contexts and consequences surrounding the use of differential feeding, with particular focus on early childhood when obesity preventative interventions may be most effective. 

Purpose: Previous research has focused on the impact of specific feeding constructs (autonomy support, structure, and control) on children’s weight status. However, less is known about how each construct relates to or differs from one another. Therefore, this study aimed to identify dimensions of caregiver feeding based on similarities and differences across reported feeding behaviors and evaluate the association between dimensions and children’s eating behaviors. Using a Self-Determination Theory framework, we hypothesized that caregivers’ feeding would fall along two dimensions based on their support of their child’s needs and how directive they are regarding their expectations of their child’s behavior at meals and that these dimensions would be associated with children’s eating behavior.

Methods: We assessed baseline data from the pilot Strong Families Start at Home Study. Participants were caregivers of 2-5-year-old children. Caregivers completed the Parent Socio-emotional Context of Feeding (PSCF) questionnaire and the Childhood Eating Behavior Questionnaire (CEBQ). A non-metric multidimensional scaling analysis was used to plot PSCF items based on similarities and differences to identify dimensions of feeding. Linear regression assessed the association between feeding dimensions and CEBQ subscales.

Results: Caregivers were predominately low-income Hispanic/Latinx mothers. A clear separation emerged between supportive (autonomy and structure) and non-supportive (chaos and control) feeding in the hypothesized direction. While autonomy support and structure differed according to levels of directiveness, control and chaos were highly similar despite having theoretically different levels of directiveness. Supportive feeding was negatively correlated with food fussiness( b= -0.30, p=.012) and emotional overeating (b= 0.27, p=.036).

Conclusions: The PSCF identified supportive and non-supportive feeding environments but did not clearly identify directiveness. This study provides further evidence that need-supportive feeding is correlated with fewer problematic eating behaviors in children and highlights a need to better understand approaches caregivers use when providing direction during feeding.

Purpose: Fathers’ engagement in infant caregiving is linked with positive social, emotional and developmental outcomes in children; however, its relationship with fathers’ own health is largely unknown. This longitudinal study examined associations between fathers’ caregiving engagement with their 6-month-old infants and their physical activity, sugar-sweetened beverage (SSB) consumption, nighttime sleep duration and depressive symptoms 6 months later when infants were 12 months old.

Methods: Participants were 143 fathers of infants (62.7% non-Hispanic white, 82.3% with a bachelor’s degree). Fathers reported their frequency of engagement in 7 caregiving activities (i.e., preparing meals, feeding, changing diapers, putting child to sleep, bathing, taking child outside the home and dressing child) when infants were 6 months old. Fathers’ physical activity, SSB consumption, nighttime sleep duration and depressive symptoms were assessed when infants were 6 and 12 months old. Multivariate logistic regression analysis was used to assess if fathers who reported higher infant caregiving at 6 months had more positive health outcomes at 12 months, controlling for fathers’ age, race/ethnicity, education, employment, household income and the outcome at 6 months.

Results: Fathers who reported higher caregiving engagement when infants were 6 months old had increased odds of being sufficiently physically active 6 months later [unadjusted OR=1.19 (95% CI=1.00, 1.41); adjusted OR=1.47 (95% CI=1.11, 1.96)]. No links were identified between fathers’ caregiving engagement and their SSB consumption, nighttime sleep duration or depressive symptoms.

Conclusions: In summary, fathers’ engagement in infant caregiving may be beneficial to their physical activity in the first year after birth. However, there was insufficient evidence in this study that the benefits of caregiving engagement were experienced broadly across multiple health outcomes.

Purpose: Despite controlling over-feeding might be associated with the duration of exclusive breastfeeding (EBF), consistent evidence to support the relationship between breastfeeding and parental styles in children with feeding difficulties is still lacking. This study was to examine the prevalence of EBF and verify the associations between EBF duration with parental styles among children with feeding difficulties. 

Methods: Cross-sectional data come from a Brazilian reference center in nutrition and feeding difficulties. Participated 194 (M=4.13; 95%CI 3.68, 4.56years, 65.98% female) children. EBF duration was assessed through parent interviews during 1st medical appointment. Parental styles were measured using the adapted Caregiver’s Feeding Styles Questionnaire (CFSQ) into four styles – Authoritative, authoritarian, indulgent, and uninvolved. Socio-demographic, weight status, and other maternal lifestyles were evaluated in order to categorize the study sample and to be used as potential confounders. Descriptive statistics and linear regressions were used. For all tests, a significant level of 5% (p<0.05) was considered. 

Results: Overall, 19.23% of the mothers reported that they never breastfed their children, while 52.31% breastfed for 6months or more. Being 6months or more EBF was more prevalent among authoritative mothers (67.65%) while being never breastfed was more prevalent among uninvolved mothers (33.33%). Adjusted models showed that indulgent (ß=2.20, 95%CI 0.67, 3.73), authoritative (ß=2.15, 95%CI 0.62, 3.68), and authoritarian mothers (ß=1.92, 95%CI 0.37, 3.47) were associated with longer exclusive breastfeeding as compared to uninvolved mothers. 

Conclusion: Controlling parental styles were positively associated with longer duration for EBF in children with feeding difficulties. Thus, a certain level of control might an important asset to encourage EBF and meet the WHO recommendations. Counseling approaches, with health care practitioners, to encourage breastfeeding and frame parental styles may benefit from targeting changes in the way parents lead with breastfeeding and other parental practices. 

Background: This study reports the outcomes of Communities for Healthy Living (CHL), a cluster randomized family-centered obesity prevention trial implemented in partnership with Head Start, a federally-funded preschool program for low-income families in the U.S.

Methods:Using a stepped wedge design, Head Start programs (n=16) were randomly assigned to one of three intervention start times. Focusing on parents as agents of change, CHL intervention activities included a media campaign, enhanced nutrition support, and a 10-week wellness program for parents, Parents Connect for Healthy Living (PConnect). At the beginning (Sept-Nov) and end (Mar-May) of each school year (2017-2019), data were collected on child BMI z-score (BMIz), child weight-related behaviors (diet, physical activity, sleep, media use), parents’ weight-related parenting practices and parent health-related empowerment (i.e., feeling in control of one’s situation and taking action). We used mixed effects linear regression to compare relative differences across the school year for Head Start families during the intervention vs. control periods (n=1219 vs. 2491) in (1) change in child BMIz, (2) the odds of meeting child health behavior recommendations, (3) change in parenting practices, and (4) change in parent empowerment. Looking specifically at intervention periods, we also compared outcomes among parents who participated in PConnect vs. not (n=50 vs. 340).

Results: During intervention periods (vs. control), children demonstrated greater – though not clinically meaningful – increases in BMIz (b=0.06, 95% CI=0.02, 0.10) and higher odds of meeting screen time recommendations (b=1.35, 95% CI=1.02, 1.80). Among parents, no statistically significant differences for intervention vs control periods were observed in parenting practices (b=0.05, 95% CI=-0.003, 0.11) or parent empowerment (b=0.04, 95% CI=-0.02, 0.11). During intervention periods, however, parents participating in PConnect (vs. not) demonstrated significantly greater increases in empowerment (b=0.18, 95% CI=0.06, 0.30).

Conclusions: Results from this intervention suggest that intervention elements which directly engage parents (e.g., PConnect) may be effective at increasing parental empowerment. With the trial prematurely suspended due to the COVID-19 pandemic, we were unable to observe longer-term changes in parenting practices and child behaviors which may have followed these empowerment increases.

Purpose: Research has shown that seeing positive facial expressions (FEs) towards food increases children’s desire to eat foods rated as disliked. However, the immediate and sustained effect of adults’ positive FEs whilst eating a vegetable on children’s eating of less preferred but nutritious foods (e.g., vegetables) remains to be established. These studies examine the effect of models’ FEs whilst eating raw broccoli on children’s eating of raw broccoli and mangetout, and examine whether one or multiple exposures to models eating a vegetable is needed to encourage children’s eating of vegetables.

Methods: Study 1 comprised 111 4-6-year-old children (64 male, 47 female) who were randomised to watch a video of unfamiliar adult models eating raw broccoli with a positive or neutral facial expression, or a non-food control video. Children’s acceptance (willingness to try and frequency of tastes) and intake of raw broccoli was assessed. Study 2 will recruit 150 5-6-year-old children who will be randomised to watch a video of adult models eating raw broccoli with a positive facial expression, or a non-food control video. Children will watch the positive video once (single exposure) or 6 times over one week (repeated exposure). Acceptance, intake and liking of raw broccoli and mangetout will be examined at session 1 and session 2 (one-week later). 

Results: Study 1 found that children who watched adults eating broccoli with positive FEs had greater frequency of tastes (p = .04) and intake of broccoli (p = .03), than children in the control condition. There was no effect of positive FEs on children’s willingness to try broccoli (p > .05). Study 2 data will be analysed using mixed ANOVA and findings will be presented. 

Conclusion: Study 1 demonstrated that observing others enjoy a commonly less liked vegetable increased children’s tastes and intake of the vegetable. This effect is expected to last over one-week, and to generalise to acceptance and intake of a similar vegetable in Study 2. If exposure to others enjoying a vegetable is effective for increasing vegetable acceptance and intake, this could be used as a basis for an intervention to encourage children’s eating of vegetables.