Maternal Concern for Child Undereating

• Published in: Academic pediatrics 2016-11, Vol.16 (8), p.777-782
• Main Authors: Brown, Callie L., MD, Pesch, Megan H., MD, MS, Perrin, Eliana M., MD, MPH, Appugliese, Danielle P., MPH, Miller, Alison L., PhD, Rosenblum, Katherine, PhD, Lumeng, Julie C., MD
• Format: Article
• Language: English
• Subjects: Body Mass Index; body weight; Child; Child Behavior; child eating behaviors; Child, Preschool; children; Cross-Sectional Studies; Feeding Behavior; feeding practices; Female; Humans; Logistic Models; Male; Mother-Child Relations; Mothers; Neonatal and Perinatal Medicine; Obesity; Odds Ratio; Overweight; Parenting; Pediatrics; pressure to eat; Surveys and Questionnaires; Thinness
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2016.06.004

Abstract Objective To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices. Methods This was a cross-sectional analysis of an observational study with 286 mother–child dyads (mean child age, 71 months). Maternal concern for undereating was assessed using a semistructured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed using videotaped mealtime observations. Logistic regression was used to assess the association of maternal and child characteristics with maternal concern for undereating. Regression was used to assess the association of maternal concern for undereating with feeding practices, controlling for covariates. Results Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child body mass index z-score (BMIz; odds ratio [OR] = 0.58; 95% confidence interval [CI], 0.43–0.77) and picky eating (OR = 2.41; 95% CI, 1.26–4.59). Maternal concern for undereating was associated with greater reported pressure to eat (relative risk [RR] = 1.97; 95% CI, 1.55–2.50), greater observed bribery (OR = 2.63; 95% CI, 1.50–4.60), and higher observed pressure (OR = 1.90; 95% CI, 1.08–3.36) during mealtimes. Conclusions Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children.