Top

Current Nutrition Reports

Published in:

01-12-2018 | Maternal and Childhood Nutrition (AC Wood, Section Editor)

Child, Caregiver, Family, and Social-Contextual Factors to Consider when Implementing Parent-Focused Child Feeding Interventions

Authors: Alison L. Miller, Sara E. Miller, Katy M. Clark

Published in: Current Nutrition Reports | Issue 4/2018

Abstract

Purpose of Review

Interventions that aim to alter child eating behaviors often focus on parents as a proximal influence. Yet, parents can be difficult to engage. Therefore, intervention recommendations are often not implemented as designed. The goal of this review is to highlight factors at multiple contextual levels that are important to consider when developing interventions to address child eating, due to their implications for overcoming parent engagement challenges.

Recent Findings

Intervention studies suggest that parents are often the key to successfully changing child eating behaviors, and many interventions focus on feeding. Factors such as child eating phenotypes, parent stress, family system dynamics, and sociodemographic constraints have also been identified as shaping food parenting.

Summary

Challenges at multiple contextual levels can affect the likelihood of parent engagement. Addressing factors at the child-, parent-, family-, and broader social-contextual levels of influence is essential in order to promote best practices for parent-focused feeding interventions.

Golan M, Crow S. Targeting parents exclusively in the treatment of childhood obesity: long-term results. Obes Res. 2004;12(2):357–61. https://doi.org/10.1038/oby.2004.45.CrossRef

Hingle MD, O’Connor TM, Dave JM, Baranowski T. Parental involvement in interventions to improve child dietary intake: a systematic review. Prev Med. 2010;51(2):103–11. https://doi.org/10.1016/j.ypmed.2010.04.014.CrossRefPubMedPubMedCentral

Howard KA, Tucker J, DeFrang R, Orth J, Wakefield S. Primary care obesity prevention in 0–2 year olds through parent nutritional counseling: evaluation of child behaviors and parent feeding styles. Pediatrics. 2018;141(1 MeetingAbstract):591. https://doi.org/10.1542/peds.141.1_MeetingAbstract.591.CrossRef

Robson SM, Stough CO, Stark LJ. The impact of a pilot cooking intervention for parent-child dyads on the consumption of foods prepared away from home. Appetite. 2016;99:177–84. https://doi.org/10.1016/j.appet.2016.01.021.CrossRefPubMed

Yan J, Liu L, Zhu Y, Huang G, Wang PP. The association between breastfeeding and childhood obesity: a meta-analysis. BMC Public Health. 2014;14(1):1267. https://doi.org/10.1186/1471-2458-14-1267.CrossRefPubMedPubMedCentral

Huh SY, Rifas-Shiman SL, Taveras EM, Oken E, Gillman MW. Timing of solid food introduction and risk of obesity in preschool-aged children. Pediatrics. 2011;127(3):e544–e51. https://doi.org/10.1542/peds.2010-0740.CrossRefPubMedPubMedCentral

Daniels LA, Mallan KM, Nicholson JM, Battistutta D, Magarey A. Outcomes of an early feeding practices intervention to prevent childhood obesity. Pediatrics. 2013;132(1):e109–18.CrossRef

8.•

Savage JS, Hohman EE, Marini ME, Shelly A, Paul IM, Birch LL. INSIGHT responsive parenting intervention and infant feeding practices: randomized clinical trial. Int J Behav Nutr Phys Act. 2018;15(1):64. https://doi.org/10.1186/s12966-018-0700-6 Intervention showing positive impact of parent feeding behavior during infancy on child weight outcomes. CrossRefPubMedPubMedCentral

Haines J, McDonald J, O’Brien A, Sherry B, Bottino CJ, Schmidt ME, et al. Healthy habits, happy homes: randomized trial to improve household routines for obesity prevention among preschool-aged children. JAMA Pediatr. 2013;167(11):1072–9. https://doi.org/10.1001/jamapediatrics.2013.2356.CrossRefPubMed

10.

Berry DC, McMurray RG, Schwartz TA, Hall EG, Neal MN, Adatorwover R. A cluster randomized controlled trial for child and parent weight management: children and parents randomized to the intervention group have correlated changes in adiposity. BMC Obes. 2017;4:39. https://doi.org/10.1186/s40608-017-0175-z.CrossRefPubMedPubMedCentral

11.•

Altman M, Wilfley DE. Evidence update on the treatment of overweight and obesity in children and adolescents. J Clin Child Adolesc Psychol. 2015;44(4):521–37. https://doi.org/10.1080/15374416.2014.963854 Review of evidence-based strategies for the treatment of overweight and obesity in children; highlights the importance of engaging families directly in treatment. CrossRefPubMed

12.

Niemeier BS, Hektner JM, Enger KB. Parent participation in weight-related health interventions for children and adolescents: a systematic review and meta-analysis. Prev Med. 2012;55(1):3–13. https://doi.org/10.1016/j.ypmed.2012.04.021.CrossRefPubMed

13.

Stifter CA, Anzman-Frasca S, Birch LL, Voegtline K. Parent use of food to soothe infant/toddler distress and child weight status. An exploratory study. Appetite. 2011;57(3):693–9. https://doi.org/10.1016/j.appet.2011.08.013.CrossRefPubMed

14.

McMeekin S, Jansen E, Mallan K, Nicholson J, Magarey A, Daniels L. Associations between infant temperament and early feeding practices. A cross-sectional study of Australian mother-infant dyads from the NOURISH randomised controlled trial. Appetite. 2013;60:239–45. https://doi.org/10.1016/j.appet.2012.10.005.CrossRefPubMed

15.

Bergmeier H, Skouteris H, Horwood S, Hooley M, Richardson B. Associations between child temperament, maternal feeding practices and child body mass index during the preschool years: a systematic review of the literature. Obes Rev. 2014;15(1):9–18. https://doi.org/10.1111/obr.12066.CrossRefPubMed

16.

Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the Children’s Eating Behaviour Questionnaire. J Child Psychol Psychiatry Allied Discip. 2001;42(7):963–70.CrossRef

17.•

Kral TVE, Moore RH, Chittams J, Jones E, O'Malley L, Fisher JO. Identifying behavioral phenotypes for childhood obesity. Appetite. 2018;127:87–96. https://doi.org/10.1016/j.appet.2018.04.021 Highlights the substantial individual differences in child appetitive traits and that not all children are equally susceptible to overeating of palatable foods, as well as implications for targeted interventions. CrossRefPubMed

18.

Ventura AK, Mennella JA. Innate and learned preferences for sweet taste during childhood. Curr Opin Clin Nutr Metab Care. 2011;14(4):379–84. https://doi.org/10.1097/MCO.0b013e328346df65.CrossRefPubMed

19.

Dovey TM, Staples PA, Gibson EL, Halford JCG. Food neophobia and ‘picky/fussy’ eating in children: a review. Appetite. 2008;50(2):181–93. https://doi.org/10.1016/j.appet.2007.09.009.CrossRefPubMed

20.

Trofholz AC, Schulte AK, Berge JM. How parents describe picky eating and its impact on family meals: a qualitative analysis. Appetite. 2017;110:36–43. https://doi.org/10.1016/j.appet.2016.11.027.CrossRefPubMed

21.

Lumeng JC, Miller AL, Appugliese D, Rosenblum K, Kaciroti N. Picky eating, pressuring feeding, and growth in toddlers. Appetite. 2018;123:299–305. https://doi.org/10.1016/j.appet.2017.12.020.CrossRefPubMed

22.

Polfuss M, Simpson P, Neff Greenley R, Zhang L, Sawin KJ. Parental feeding behaviors and weight-related concerns in children with special needs. West J Nurs Res. 2017;39(8):1070–93. https://doi.org/10.1177/0193945916687994.CrossRefPubMed

23.

Must A, Curtin C, Hubbard K, Sikich L, Bedford J, Bandini L. Obesity prevention for children with developmental disabilities. Curr Obes Rep. 2014;3(2):156–70. https://doi.org/10.1007/s13679-014-0098-7.CrossRefPubMedPubMedCentral

24.

Belsky J, van IJzendoorn MH. Genetic differential susceptibility to the effects of parenting. Curr Opin Psychol. 2017;15:125–30. https://doi.org/10.1016/j.copsyc.2017.02.021.CrossRefPubMed

25.

Bauer KW, Haines J, Miller AL, Rosenblum K, Appugliese DP, Lumeng JC, et al. Maternal restrictive feeding and eating in the absence of hunger among toddlers: a cohort study. Int J Behav Nutr Phys Act. 2017;14(1):172. https://doi.org/10.1186/s12966-017-0630-8.CrossRefPubMedPubMedCentral

26.

Larsen, J. K., Hermans, R. C., Sleddens, E. F., Engels, R. C., Fisher, J. O., & Kremers, S. P. (2015). How parental dietary behavior and food parenting practices affect children's dietary behavior. Interacting sources of influence?. Appetite, 89, 246-257.CrossRef

27.

Bauer KW, Weeks HM, Lumeng JC, Miller AL, Gearhardt AN Maternal executive function and the family food environment. Under Review

28.

Swyden K, Sisson SB, Morris AS, Lora K, Weedn AE, Copeland KA, et al. Association between maternal stress, work status, concern about child weight, and restrictive feeding practices in preschool children. Matern Child Health J. 2017;21(6):1349–57. https://doi.org/10.1007/s10995-016-2239-y.CrossRefPubMed

29.

Bauer KW, Hearst MO, Escoto K, Berge JM, Neumark-Sztainer D. Parental employment and work-family stress: associations with family food environments. Soc Sci Med. 2012;75(3):496–504. https://doi.org/10.1016/j.socscimed.2012.03.026.CrossRefPubMedPubMedCentral

30.

Goulding AN, Rosenblum KL, Miller AL, Peterson KE, Chen Y-P, Kaciroti N, et al. Associations between maternal depressive symptoms and child feeding practices in a cross-sectional study of low-income mothers and their young children. Int J Behav Nutr Phys Act. 2014;11(1):75. https://doi.org/10.1186/1479-5868-11-75.CrossRefPubMedPubMedCentral

31.

Dennis CL, McQueen K. The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review. Pediatrics. 2009;123(4):e736.CrossRef

32.

Coyne SM, McDaniel BT, Stockdale LA. “Do you dare to compare?” associations between maternal social comparisons on social networking sites and parenting, mental health, and romantic relationship outcomes. Comput Hum Behav. 2017;70:335–40. https://doi.org/10.1016/j.chb.2016.12.081.CrossRef

33.

Henderson A, Harmon S, Newman H. The price mothers pay, even when they are not buying it: mental health consequences of idealized motherhood. Sex Roles. 2016;74(11):512–26. https://doi.org/10.1007/s11199-015-0534-5.CrossRef

34.•

Zenlea IS, Thompson B, Fierheller D, Green J, Ulloa C, Wills A, et al. Walking in the shoes of caregivers of children with obesity: supporting caregivers in paediatric weight management. Clin Obes. 2017;7(5):300–6. https://doi.org/10.1111/cob.12202 Qualitative paper highlighting feelings of isolation and blame in caregivers of children with obesity. CrossRefPubMed

35.

Bahreynian M, Qorbani M, Khaniabadi BM, Motlagh ME, Safari O, Asayesh H, et al. Association between obesity and parental weight status in children and adolescents. J Clin Res Pediatr Endocrinol. 2017;9(2):111–7. https://doi.org/10.4274/jcrpe.3790.CrossRefPubMedPubMedCentral

36.

Holub SC, Tan CC, Patel SL. Factors associated with mothers’ obesity stigma and young children’s weight stereotypes. J Appl Dev Psychol. 2011;32(3):118–26. https://doi.org/10.1016/j.appdev.2011.02.006.CrossRef

37.

Andreassen P, Grøn L, Roessler KK. Hiding the plot:parents’ moral dilemmas and strategies when helping their overweight children lose weight. Qual Health Res. 2013;23(10):1333–43. https://doi.org/10.1177/1049732313505151.CrossRefPubMed

38.

Devine CM, Connors MM, Sobal J, Bisogni CA. Sandwiching it in: spillover of work onto food choices and family roles in low- and moderate-income urban households. Soc Sci Med (1982). 2003;56(3):617–30.CrossRef

39.•

Loth KA, Nogueira de Brito J, Neumark-Sztainer D, Fisher JO, Berge JM. A qualitative exploration into the parent-child feeding relationship: how parents of preschoolers divide the responsibilities of feeding with their children. J Nutr Educ Behav. 2018;50(7):655–67. https://doi.org/10.1016/j.jneb.2018.03.004 Qualitative paper highlighting parent decision-making, schedule constraints, and parent roles in feeding young children. CrossRefPubMed

40.

Devine CM, Farrell TJ, Blake CE, Jastran M, Wethington E, Bisogni CA. Work conditions and the food choice coping strategies of employed parents. J Nutr Educ Behav. 2009;41(5):365–70. https://doi.org/10.1016/j.jneb.2009.01.007.CrossRefPubMedPubMedCentral

41.

Wiersma LD, Fifer AM. “The schedule has been tough but we think it’s worth it”: the joys, challenges, and recommendations of youth sport parents. J Leis Res. 2008;40(4):505–30. https://doi.org/10.1080/00222216.2008.11950150.CrossRef

42.

Owens JA, Belon K, Moss P. Impact of delaying school start time on adolescent sleep, mood, and behavior. Arch Pediatr Adolesc Med. 2010;164(7):608–14. https://doi.org/10.1001/archpediatrics.2010.96.CrossRefPubMed

43.

Thullen M, Majee W, Davis AN. Co-parenting and feeding in early childhood: reflections of parent dyads on how they manage the developmental stages of feeding over the first three years. Appetite. 2016;105:334–43. https://doi.org/10.1016/j.appet.2016.05.039.CrossRefPubMed

44.

Khandpur N, Charles J, Davison KK. Fathers’ perspectives on coparenting in the context of child feeding. Child Obes. 2016;12(6):455–62. https://doi.org/10.1089/chi.2016.0118.CrossRefPubMed

45.

Davison KK, Gicevic S, Aftosmes-Tobio A, Ganter C, Simon CL, Newlan S, et al. Fathers’ representation in observational studies on parenting and childhood obesity: a systematic review and content analysis. Am J Public Health. 2016;106(11):e14–21. https://doi.org/10.2105/AJPH.2016.303391.CrossRefPubMedPubMedCentral

46.

Tan CC, Domoff S, Pesch MH, Lumeng JC, Miller AL. Coparenting in the feeding context: perspectives of fathers and mothers of preschoolers. Under Review.

47.

Wilfley DE, Saelens BE, Stein RI, Best JR, Kolko RP, Schechtman KB, et al. Dose, content, and mediators of family-based treatment for childhood obesity: a multisite randomized clinical trial. JAMA Pediatr. 2017;171(12):1151–9. https://doi.org/10.1001/jamapediatrics.2017.2960.CrossRefPubMedPubMedCentral

48.•

Quattrin T, Cao Y, Paluch RA, Roemmich JN, Ecker MA, Epstein LH. Cost-effectiveness of family-based obesity treatment. Pediatrics. 2017;140(3). doi:https://doi.org/10.1542/peds.2016-2755. Study compared an information-only to a family-based treatment for children with obesity and found family-based treatment to be more cost-effective. CrossRef

49.

Kral TVE, Chittams J, Moore RH. Relationship between food insecurity, child weight status, and parent-reported child eating and snacking behaviors. J Spec Pediatr Nurs. 2017;22(2):e12177. https://doi.org/10.1111/jspn.12177.CrossRef

50.

Feinberg E, Kavanagh PL, Young RL, Prudent N. Food insecurity and compensatory feeding practices among urban black families. Pediatrics. 2008;122(4):e854–60.CrossRef

51.

Herman AN, Malhotra K, Wright G, Fisher JO, Whitaker RC. A qualitative study of the aspirations and challenges of low-income mothers in feeding their preschool-aged children. Int J Behav Nutr Phys Act. 2012;9(1):132. https://doi.org/10.1186/1479-5868-9-132.CrossRefPubMedPubMedCentral

52.

Bruening M, MacLehose R, Loth K, Story M, Neumark-Sztainer D. Feeding a family in a recession: food insecurity among Minnesota parents. Am J Public Health. 2012;102(3):520–6. https://doi.org/10.2105/AJPH.2011.300390.CrossRefPubMedPubMedCentral

53.

Kumanyika SK. Environmental influences on childhood obesity: ethnic and cultural influences in context. Physiol Behav. 2008;94(1):61–70. https://doi.org/10.1016/j.physbeh.2007.11.019.CrossRefPubMed

54.

Cachelin FM, Thompson D. Predictors of maternal child-feeding practices in an ethnically diverse sample and the relationship to child obesity. Obesity. 2013;21(8):1676–83. https://doi.org/10.1002/oby.20385.CrossRefPubMed

55.

Hughes SO, Anderson CB, Power TG, Micheli N, Jaramillo S, Nicklas TA. Measuring feeding in low-income African–American and Hispanic parents. Appetite. 2006;46(2):215–23. https://doi.org/10.1016/j.appet.2006.01.002.CrossRefPubMed

56.•

Davison KK, Jurkowski JM, Li K, Kranz S, Lawson HA. A childhood obesity intervention developed by families for families: results from a pilot study. Int J Behav Nutr Phys Act. 2013;10(1):3 Intervention that was developed and led by parents in Head Start showed positive impact on child diet as well as obesity rates, and parents reported higher self-efficacy in promoting healthy eating. CrossRef

57.

Gruver RS, Bishop-Gilyard CT, Lieberman A, Gerdes M, Virudachalam S, Suh AW, et al. A social media peer group intervention for mothers to prevent obesity and promote healthy growth from infancy: development and pilot trial. JMIR Res Protoc. 2016;5(3):e159. https://doi.org/10.2196/resprot.5276.CrossRefPubMedPubMedCentral

58.•

Fiks AG, Gruver RS, Bishop-Gilyard CT, Shults J, Virudachalam S, Suh AW, et al. A social media peer group for mothers to prevent obesity from infancy: The Grow2Gether randomized trial. Child Obes. 2017;13(5):356–68. https://doi.org/10.1089/chi.2017.0042 Pilot RCT found that low-income mothers recruited during pregnancy participated in a social media intervention (Facebook group) and that intervention mothers reported change in infant feeding strategies at 6 months of age. CrossRefPubMedPubMedCentral

59.

Ullmann G, Kedia SK, Homayouni R, Akkus C, Schmidt M, Klesges LM, et al. Memphis FitKids: implementing a mobile-friendly web-based application to enhance parents’ participation in improving child health. BMC Public Health. 2018;18:1068. https://doi.org/10.1186/s12889-018-5968-6.CrossRefPubMedPubMedCentral

60.

Marks AK, Ejesi K, García CC. Understanding the U.S. immigrant paradox in childhood and adolescence. Child Dev Perspect. 2014;8(2):59–64. https://doi.org/10.1111/cdep.12071.CrossRef

61.

Bates LM, Acevedo-Garcia D, Alegría M, Krieger N. Immigration and generational trends in body mass index and obesity in the United States: results of the National Latino and Asian American Survey, 2002–2003. Am J Public Health. 2008;98(1):70–7. https://doi.org/10.2105/ajph.2006.102814.CrossRefPubMedPubMedCentral

62.

Baker EH, Rendall MS, Weden MM. Epidemiological paradox or immigrant vulnerability? Obesity among young children of immigrants. Demography. 2015;52(4):1295–320. https://doi.org/10.1007/s13524-015-0404-3.CrossRefPubMedPubMedCentral

63.

Fuller B, Bridges M, Bein E, Jang H, Jung S, Rabe-Hesketh S, et al. The health and cognitive growth of Latino toddlers: at risk or immigrant paradox? Matern Child Health J. 2009;13(6):755–68. https://doi.org/10.1007/s10995-009-0475-0.CrossRefPubMedPubMedCentral

64.•

Power TG, O’Connor TM, Orlet Fisher J, Hughes SO. Obesity risk in children: the role of acculturation in the feeding practices and styles of low-income hispanic families. Child Obes. 2015;11(6):715–21. https://doi.org/10.1089/chi.2015.0036 Observational study finding that first-generation immigrant mothers showed more controlling feeding practices, and mothers born in the US showed more indulgent feeding practices, among low-income Hispanic mothers. CrossRefPubMedPubMedCentral

65.

Martinez O, Wu E, Sandfort T, Dodge B, Carballo-Dieguez A, Pinto R, et al. Evaluating the impact of immigration policies on health status among undocumented immigrants: a systematic review. J Immigr Minor Health. 2015;17(3):947–70. https://doi.org/10.1007/s10903-013-9968-4.CrossRefPubMedPubMedCentral

66.

Quandt SA, Shoaf JI, Tapia J, Hernández-Pelletier M, Clark HM, Arcury TA. Experiences of Latino immigrant families in North Carolina help explain elevated levels of food insecurity and hunger. J Nutr. 2006;136(10):2638–44. https://doi.org/10.1093/jn/136.10.2638.CrossRefPubMedPubMedCentral

Title: Child, Caregiver, Family, and Social-Contextual Factors to Consider when Implementing Parent-Focused Child Feeding Interventions
Authors: Alison L. Miller
Sara E. Miller
Katy M. Clark
Publication date: 01-12-2018
Publisher: Springer US
Published in: Current Nutrition Reports / Issue 4/2018
Electronic ISSN: 2161-3311
DOI: https://doi.org/10.1007/s13668-018-0255-9

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 4/2018

An Intergenerational Approach to Break the Cycle of Malnutrition

Dairy Consumption and Cardiometabolic Diseases: Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies

Role of Gut Microbiota-Generated Short-Chain Fatty Acids in Metabolic and Cardiovascular Health

Dietary Patterns, Physical Activity, Sleep, and Risk for Dementia and Cognitive Decline

To Pull or Not to Pull: Salvaging Central Line Catheters in Home Parenteral Nutrition

Weight Regain After Bariatric Surgery: Prevalence, Etiology, and Treatment

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage