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      Association between feeding practices and weight status in young children

      research-article
      , , , ,
      BMC Pediatrics
      BioMed Central
      Children, Feeding practices, Overweight

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          Abstract

          Background

          Inappropriate feeding practices during infancy may lead to overweight. The aims of this study are to investigate the growth of children in the first 18 months of life; to evaluate the feeding practices of caregivers using developed Young Child Feeding Questionnaire; and to investigate caregivers’ feeding attitudes and behaviors associated with infants’ weight status.

          Methods

          Six month-old infants and their main caregivers entering the Kongjiang Community Health Center for a routine well-child check were recruited for this study and followed up every 6 months for 12 months. Questionnaire survey was carried out through on-site face-to-face interview at each visit with the main caregivers of children using Young Child Feeding Questionnaire, which included caregivers’ feeding attitudes and behaviors. The weight and length of children were measured at each visit.

          Results

          Among 197 children who completed the investigation at 18 months of age, 64 (32.49 %) children were overweight (BMI-for-age z scores > +1). The increases in weight-for-age z scores and BMI-for-age z scores from birth to 6 months, 12 to 18 months and birth to 18 months in overweight children were significantly higher than those in normal weight children ( P < 0.001). In normal weight children, caregivers worried more about children’s being “underweight” and “eating less” ( P = 0.001), whereas caregivers with overweight children worried more about children’s “eating too much” and being “overweight” ( P < 0.001). In 64 overweight infants, the scores of “concern about child’s food intake” were significantly correlated with increase in BAZ between 12 and 18 months ( Bata = 0.293, P = 0.029).

          Conclusions

          Young Child Feeding Questionnaire is a valid tool for evaluating feeding practice of caregivers. The rapid BMI gain in overweight children may be associated with some inappropriate feeding attitudes and behaviors of caregivers.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12887-015-0418-4) contains supplementary material, which is available to authorized users.

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          Most cited references25

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          Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness.

          The Child Feeding Questionnaire (CFQ) is a self-report measure to assess parental beliefs, attitudes, and practices regarding child feeding, with a focus on obesity proneness in children. Confirmatory factor analysis tested a 7-factor model, which included four factors measuring parental beliefs related to child's obesity proneness, and three factors measuring parental control practices and attitudes regarding child feeding. Using a sample of 394 mothers and fathers, three models were tested, and the third model confirmed an acceptable fit, including correlated factors. Internal consistencies for the seven factors were above 0.70. With minor changes, this same 7-factor model was also confirmed in a second sample of 148 mothers and fathers, and a third sample of 126 Hispanic mothers and fathers. As predicted, four of the seven factors were related to an independent measure of children's weight status, providing initial support for the validity of the instrument. The CFQ can be used to assess aspects of child-feeding perceptions, attitudes, and practices and their relationships to children's developing food acceptance patterns, the controls of food intake, and obesity. The CFQ is designed for use with parents of children ranging in age from about 2 to 11 years of age. Copyright 2000 Academic Press.
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            Comprehensive Feeding Practices Questionnaire: validation of a new measure of parental feeding practices.

            Measures of parents' feeding practices have focused primarily on parental control of feeding and have not sufficiently measured other potentially important practices. The current study validates a new measure of feeding practices, the Comprehensive Feeding Practices Questionnaire (CFPQ). The first study validated a 9-factor feeding practice scale for mothers and fathers. In the second study, open-ended questions solicited feeding practices from parents to develop a more comprehensive measure of parental feeding. The third study validated an expanded 12-factor feeding practices measure with mothers of children from 2 to 8 years of age. The CFPQ appears to be an adequate tool for measuring the feeding practices of parents of young children. Researchers, clinicians, and health educators might use this measure to better understand how parents feed their children, the factors that contribute to these practices, and the implications of these practices on children's eating behaviors.
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              Parent-child feeding strategies and their relationships to child eating and weight status.

              Parental feeding styles may promote overeating or overweight in children. A comprehensive literature review was undertaken to summarize the associations between parental feeding styles and child eating and weight status. Twenty-two studies were identified. We systematically coded study attributes and outcomes and tested for patterns of association. Nineteen studies (86%) reported at least one significant association between parental feeding style and child outcome, although study methodology and results varied considerably. Studies measuring parental feeding restriction, as opposed to general feeding control or another feeding domain, were more likely to report positive associations with child eating and weight status. Certain associations differed by gender and by outcome measurement (e.g., rate of eating as opposed to total energy intake). Parental feeding restriction, but no other feeding domain, was associated with increased child eating and weight status. Longitudinal studies are needed to test underlying causal pathways, including bidirectional causal models, and to substantiate findings in the presence of other obesity risk factors.
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                Author and article information

                Contributors
                xhkcb105@163.com
                zhoulili1011@163.com
                huyanqiaa@hotmail.com
                lss851010@126.com
                +86 13818072645 , +8621 25076445 , shengxiaoyangcn@aliyun.com
                Journal
                BMC Pediatr
                BMC Pediatr
                BMC Pediatrics
                BioMed Central (London )
                1471-2431
                26 August 2015
                26 August 2015
                2015
                : 15
                : 97
                Affiliations
                Department of Child and Adolescent Healthcare, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai Institute for Pediatric Research, Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No.1665, Kongjiang Road, Yangpu District, Shanghai, 200092 China
                Article
                418
                10.1186/s12887-015-0418-4
                4550067
                9965cec5-8fa6-4de6-8700-f0bc129d3f58
                © Ma et al. 2015

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 August 2014
                : 13 August 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Pediatrics
                children,feeding practices,overweight
                Pediatrics
                children, feeding practices, overweight

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