The ability to perceive flavors begins in utero with the development and early functioning of the gustatory and olfactory systems. Because both amniotic fluid and breast milk contain molecules ...derived from the mother’s diet, learning about flavors in foods begins in the womb and during early infancy. This early experience serves as the foundation for the continuing development of food preferences across the lifespan, and is shaped by the interplay of biological, social, and environmental factors. Shortly after birth, young infants show characteristic taste preferences: sweet and umami elicit positive responses; bitter and sour elicit negative responses. These taste preferences may reflect a biological drive towards foods that are calorie- and protein-dense and an aversion to foods that are poisonous or toxic. Early likes and dislikes are influenced by these innate preferences, but are also modifiable. Repeated exposure to novel or disliked foods that occurs in a positive, supportive environment may promote the acceptance of and eventually a preference for those foods. Alternatively, children who are pressured to eat certain foods may show decreased preference for those foods later on. With increasing age, the influence of a number of factors, such as peers and food availability, continue to mold food preferences and eating behaviors.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Worldwide, the prevalence of obesity among children has increased dramatically. Although the etiology of childhood obesity is multifactorial, to date, most preventive interventions have focused on ...school-aged children in school settings and have met with limited success. In this review, we focus on another set of influences that impact the development of children's eating and weight status: parenting and feeding styles and practices. Our review has two aims: (1) to assess the extent to which current evidence supports the hypothesis that parenting, via its effects on children's eating, is causally implicated in childhood obesity; and (2) to identify a set of promising strategies that target aspects of parenting, which can be further evaluated as possible components in childhood obesity prevention.
A literature review was conducted between October 2006 and January 2007. Studies published before January 2007 that assessed the association between some combination of parenting, child eating and child weight variables were included.
A total of 66 articles met the inclusion criteria. The preponderance of these studies focused on the association between parenting and child eating. Although there was substantial experimental evidence for the influence of parenting practices, such as pressure, restriction, modeling and availability, on child eating, the majority of the evidence for the association between parenting and child weight, or the mediation of this association by child eating, was cross-sectional.
To date, there is substantial causal evidence that parenting affects child eating and there is much correlational evidence that child eating and weight influence parenting. There are few studies, however, that have used appropriate meditational designs to provide causal evidence for the indirect effect of parenting on weight status via effects on child eating. A new approach is suggested for evaluating the effectiveness of intervention components and creating optimized intervention programs using a multiphase research design. Adoption of approaches such as the Multiphase Optimization Strategy (MOST) is necessary to provide the mechanistic evidence-base needed for the design and implementation of effective childhood obesity prevention programs.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The first 2 years of life have been recognized as a critical window for obesity prevention efforts. This period is characterized by rapid growth and development and, in a relatively short period of ...time, a child transitions from a purely milkbased diet to a more varied solid-food diet. Much learning about food and eating occurs during this critical window, and it is well-documented that early feeding and dietary exposures predict later food preferences, eating behaviors, and dietary patterns. The focus of this review will be on the earliest feeding experiences–breast-and formula-feeding the unique role of breastfeeding in shaping children’s food preferences. Epidemiological data illustrate that children who were breastfed have healthier dietary patterns compared to children who were formula-fed, even after controlling for relevant sociodemographic characteristics associated with healthier dietary and lifestyle patterns. These dietary differences are underlined, in part, by early differences in the opportunities for flavor learning and preference development afforded by breast-versus formula-feeding. In particular, the flavors of the mothers’ diet are transmitted from mother to child through the amniotic fluid and breastmilk. The flavors experienced in these mediums shape later food preferences and acceptance of the solid foods of the family and culture onto which the infant is weaned. All infants learn from flavor experiences in utero, but only breastfed infants receive the additional reinforcement and flavor learning provided by continued repeated exposure to a wide variety of flavors that occurs during breastfeeding. Given the numerous benefits of breastfeeding, promotion of breastfeeding during early infancy is an important focus for primary prevention efforts and should be combined with efforts to ensure that mothers consume healthy, varied diets during pregnancy and lactation, and expose their infants to a wide array of foods during weaning and solid-food feeding.
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BFBNIB, NMLJ, NUK, PNG, UL, UM, UPUK
Recent recommendations and prevention programs have focused on the promotion of responsive feeding during infancy, but more research is needed to understand best practices for fostering responsive ...feeding during early life. The objective of this systematic review was to synthesize the accumulating bodies of evidence aimed at understanding associations between mothers' feeding experiences and responsive feeding in an attempt to clarify the nature of associations between feeding mode and responsive feeding. A literature search was conducted between January and October 2016; articles were collected from PsychINFO, Medline, and CINAHL, as well as from references in published research and reviews. Article inclusion criteria were as follows: 1) empirical research, 2) included a measure of infant feeding, 3) included a measure of maternal responsiveness, 4) study conducted in human participants, 5) available in English, and 6) study conducted in a developed and/or high-income country. Forty-three studies were identified. Cross-sectional observational studies consistently reported greater responsiveness among breastfeeding mothers than among formula-/bottle-feeding mothers. In addition, longitudinal studies showed that longer breastfeeding durations predicted lower use of nonresponsive feeding practices during later childhood, and some, but not all, found that breastfeeding mothers showed greater increases in responsiveness across infancy than did formula-/bottle-feeding mothers. However, a limited number of longitudinal studies also reported that greater responsiveness during early infancy predicted longer breastfeeding durations. A common limitation among these studies is the correlational nature of their designs and lack of prenatal measures of maternal responsiveness, which hinders our understanding of causal mechanisms. Although 2 randomized clinical trials aimed at promoting maternal responsiveness did not find effects of the intervention on breastfeeding outcomes, these findings were limited by the way in which breastfeeding outcomes were assessed. In sum, although there is consistent evidence for an association between breastfeeding and responsive feeding, more research is needed to better understand the mechanisms underlying this association.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Experimental research with parents of older children suggests parents’ engagement with technological devices (e.g., television, mobile devices) in the presence of their children decreases the quality ...of parent-child interactions. Many mothers report frequent use of technological devices during infant feeding but, to date, few studies have explored the potential association between maternal technological device use during feeding and the quality of infant feeding interactions. To this end, mothers (n = 25) and their infants (mean age = 19.3 ± 6.4 weeks) participated in a within-subject, experimental study to explore associations between maternal digital media use and feeding interaction quality within a laboratory setting. Dyads were video-recorded while breastfeeding under two counterbalanced conditions: Digital Media Use versus Control. Mothers engaged their infants in significantly less cognitive growth fostering during the Digital Media Use compared to Control condition. Infants of mothers with typically low levels of technology use during feeding showed a significant decrease in their responsiveness to their mother during the Digital Media Use compared to Control condition. These results illustrate maternal digital media use was associated with decreases in some, but not all, aspects of the quality of the feeding interaction, meriting further investigation with larger, more diverse samples.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To describe patterns of bottle-feeding across the first year postpartum and explore whether bottle-feeding trajectories are differentially associated with infant weight gain.
Data came from 1291 ...mothers who participated in the Infant Feeding Practices Study 2. Mothers completed a prenatal questionnaire and monthly surveys of infant feeding and growth between birth and 12 months. Group-based trajectory mixture modeling was used to describe developmental trajectories of bottle-feeding intensities across the first year. Growth curve modeling was used to explore associations between bottle-feeding intensity trajectory group membership and weight-for-age z-score (WAZ) trajectories from birth to 12 months.
Four qualitatively distinct trajectories of bottle-feeding were identified: (1) High-Stable: ∼100% of feeds from bottles across infancy; (2) Rapid-Increase: <30% of feeds from bottles during the neonatal assessment, increasing to ∼100% by 6 months; (3) Gradual-Increase: <10% of feeds from bottles during the neonatal assessment, gradually increasing to ∼100% by 12 months; and (4) Low-Stable: <5% of feeds from bottles across the majority of infancy. Bottle-feeding groups had significantly different WAZ trajectories across infancy; by 12 months, the High-Stable and Rapid-Increase groups had significantly higher WAZs compared with the Gradual-Increase and Low-Stable groups (p < .001). The association between bottle-feeding group membership and WAZ trajectories was not confounded by sociodemographic characteristics or the extent to which infants received breast milk.
High-intensity bottle use during early infancy may place infants at higher risk for excess weight gain. Supports and policies that help mothers delay high-intensity bottle use until later infancy are warranted.
Recommendations aimed at reducing infants’ risk for rapid weight gain primarily focus on promoting caregivers’ use of responsive feeding practices and styles. These recommendations are grounded in ...the belief that infants will effectively signal hunger and satiation to their caregivers. To date, few studies have explored how variability in infants’ communication of hunger and satiation may contribute to feeding interactions.
Our aim was to explore variability in, and correlates of, infant clarity of cues during feeding interactions.
This was a cross-sectional study.
Mother–infant dyads (n=86) were video-recorded during a typical feeding interaction within laboratory-based settings in Philadelphia, PA and San Luis Obispo, CA between June 2013 and June 2017.
Trained raters later coded videos using the Nursing Child Assessment Parent–Child Interaction Feeding Scale’s Infant Clarity of Cues and Maternal Sensitivity to Cues subscales. Infant weight was assessed and standardized to sex- and age-specific z scores. Mothers completed questionnaires related to family demographics, infant feeding history, feeding styles, and infant temperament and eating behaviors.
Linear models were used to test for associations between clarity of cues and breastfeeding vs formula-feeding, maternal sensitivity and responsiveness, and feeding and weight outcomes.
Infants were approximately 15.5 weeks of age and 53% were female. Clarity of cues was not associated with infant sex, age, temperament, or eating behaviors. Breastfed and formula-fed infants exhibited similar clarity of cues (P=0.0636). Greater clarity of cues for infants was associated with greater maternal sensitivity to cues (P=0.0011) and responsive feeding style (P=0.0464) for mothers. Lower clarity of cues was associated with greater weight-for-age z score change for formula-fed infants, but not breastfed infants.
Efforts to promote responsive feeding may need to also consider infant clarity of cues. Further research is needed to understand the implications of associations between infant communication and responsive feeding.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PURPOSE OF REVIEWIn nature, carbohydrates are a source of energy often equated with sweetness, the detection of which is associated with powerful hedonic appeal. Intakes of processed carbohydrates in ...the form of added sugars and sugar-sweetened beverages have risen consistently among all age groups over the last two decades. In this review, we describe the biological underpinnings that drive the consumption of sweet-tasting foods among pediatric populations.
RECENT FINDINGSScientific literature suggests that childrenʼs liking for all that is sweet is not solely a product of modern-day technology and advertising but reflects their basic biology. In fact, heightened preference for sweet-tasting foods and beverages during childhood is universal and evident among infants and children around the world. The liking for sweet tastes during development may have ensured the acceptance of sweet-tasting foods, such as motherʼs milk and fruits. Moreover, recent research suggests that liking for sweets may be further promoted by the pain-reducing properties of sugars.
SUMMARYAn examination of the basic biology of sweet taste during childhood provides insight, as well as new perspectives, for how to modify childrenʼs preferences for and intakes of sweet foods to improve their diet quality.
To explore the prevalence and correlates of maternal distraction during infant feeding within a sample of mothers enrolled or not in the Special Supplemental Nutrition Program for Woman, Infants, and ...Children (WIC).
Mothers kept diaries of their infants' feeding patterns.
Mothers (n = 75) with infants aged ≤6 months.
Within the diaries, mothers recorded what else, if anything, they did during the feeding. Mothers also completed questionnaires on demographics, feeding styles, and infant temperament and eating behaviors.
Mothers' responses were coded into thematic categories. Feedings were classified as distracted when the mothers reported doing something other than feeding and/or interacting with the infant. Logistic regression was used to explore whether mothers exhibited different levels of distraction when breastfeeding (BF) vs bottle feeding. The researchers used multiple stepwise regression to explore associations between distracted feeding and characteristics of mothers and infants.
Distractions were reported during 43% of feedings; 26% involved technological distractors. Mothers who were multiparous and perceived that their infants had greater appetites reported greater levels of any distraction during feeding. Mothers who were of racial/ethnic minorities, adhered to laissez faire feeding style, had younger infants, and perceived their infants to have lower food responsiveness and greater appetite reported greater levels of technological distraction. Being enrolled in WIC was not associated with mothers' levels of distracted feeding.
Mothers reported a wide variety of distractions during both BF and bottle feeding; higher levels of distraction were associated with characteristics of both mothers and infants. Further research is needed to understand whether and how maternal distraction affects feeding outcomes. Awareness of such distractions and their potential impact would be useful to practitioners working with pregnant and postpartum women.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The aim of this study was to explore associations between parenting stress, feeding practices, and perceptions of children's eating behaviors during the COVID-19 pandemic. Parents (n = 284) of ...children ages 4–6 years completed a cross-sectional online survey during the onset of pandemic-related stay-at-home mandates in the U.S. Parents reported current levels of parenting stress, feeding practices, and child eating behaviors. Parents also reported whether parenting stress had increased, stayed the same, or decreased since prior to the onset of pandemic-related stay-at-home mandates. Greater levels of parenting stress were associated with less desirable feeding practices, including greater odds of high use of food for emotional regulation (OR = 1.05, 95% CI = 1.03–1.08), food as a reward (OR = 1.05, 95% CI = 1.02–1.08), and pressure to eat (OR = 1.03, 95% CI = 1.01–1.06), and low use of encouraging a balanced diet (OR = 1.03, 95% CI = 1.01–1.06). Greater levels of parenting stress were also associated with greater perceptions that children exhibited problematic eating behaviors, including greater odds of high food fussiness (OR = 1.05, 95% CI = 1.02–1.08) and low enjoyment of food (OR = 1.05, 95% CI = 1.02–1.07). For parents who reported their parenting stress had increased, greater parenting stress was associated with more frequent use of pressure to eat (p = .009) and less frequent monitoring their child's diet (p = .028). In conclusion, parenting stress during the pandemic was associated with use of food for emotional and behavioral regulation and perceptions that children exhibited problematic eating behaviors. Further research is needed to understand how to mitigate parenting stress and promote healthy feeding practices during times of crisis.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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