RESUMEN
Mealtime is a parent-toddler interaction that occurs multiple times a day. This study examined whether observed maternal sensitivity differed between a mealtime and free-play setting, aiming to explain differences between the two situations by studying moderating effects of children's eating behavior. The sample consisted of 103 first-time mothers and their 18-month-old children. Maternal sensitivity was assessed by coding videotaped interactions of free-play sessions and mealtimes, using the Ainsworth Sensitivity Scale (range 1-9). Additionally, child eating behavior during the meal was coded and also assessed through the Child Eating Behavior Questionnaire-Toddlers. First, a small but significant amount of stability was found between sensitivity during mealtime and sensitivity during play (r = 0.24). Second, mothers were more sensitive during free play (mean = 7.11) than during mealtime (mean = 6.52). Third, observed child eating behavior was related to maternal sensitivity during mealtime, with more food enjoyment being associated with higher levels of sensitivity, and more challenging child behavior with lower levels of sensitivity. Finally, when children showed a high degree of challenging behavior during the meal, there was more discrepancy between sensitivity during mealtime and free play. Our results highlight the importance of taking context into account when observing parental sensitivity.
Asunto(s)
Conducta Alimentaria , Comidas , Niño , Conducta Infantil , Femenino , Humanos , Lactante , Madres , PadresRESUMEN
BACKGROUND: Parenting interventions during the first years of life on what and/or how to feed infants during complementary feeding can promote healthy eating habits. OBJECTIVES: An intervention promoting repeated exposure to a variety of vegetables [repeated vegetable exposure (RVE); what] and an intervention promoting responding sensitively to child signals during mealtime [video-feedback intervention to promote positive parenting-feeding infants (VIPP-FI); how] were compared, separately and combined (COMBI), with an attention control condition (AC). Primary outcomes were vegetable consumption and self-regulation of energy intake; secondary outcomes were child anthropometrics and maternal feeding practices (sensitive feeding, pressure to eat). METHODS: Our 4-arm randomized controlled trial included 246 first-time Dutch mothers and their infants. Interventions started when infants were 4-6 mo old and ended at age 16 mo. The present study evaluated effects at 18 (t18) and 24 (t24) mo of age. Vegetable acceptance was assessed using three 24-h dietary recalls, self-regulation of energy intake by an eating-in-the-absence-of-hunger experiment and mother-report, and maternal feeding behavior by observation and mother-report. RESULTS: Linear mixed model and ANOVA analyses revealed no follow-up group differences regarding child vegetable intake or self-regulatory behavior. The proportion of children with overweight was significantly lower in the COMBI group, compared with the VIPP-FI group at t18 (2% compared with 16%), and with the AC group at t24 (7% compared with 20%), although this finding needs to be interpreted cautiously due to the small number of infants with overweight and nonsignificant effects on the continuous BMI z-score measure (P values: 0.29-0.82). Finally, more sensitive feeding behavior and less pressure to eat was found in the VIPP-FI and COMBI groups, compared with the RVE and AC groups, mostly at t18 (significant effect sizes: d = 0.23-0.64). CONCLUSIONS: Interventions were not effective in increasing vegetable intake or self-regulation of energy intake. Future research might usefully focus on risk groups such as families who already experience problems around feeding.This trial is registered at clinicaltrials.gov as NCT03348176.
Asunto(s)
Conducta Alimentaria , Verduras , Adolescente , Niño , Conducta Infantil , Dieta , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante , Evaluación de Resultado en la Atención de SaludRESUMEN
Family meals are associated with multiple health benefits in children and adolescents including evidence that eating together as a family may play a role in reducing childhood obesity. The current review aims to investigate whether the beneficial health effects of the family meal also apply to infants and toddlers. PubMed, Web of Science, Scopus and PsycInfo were searched and 14 empirical studies were identified. The findings were discussed according to frequency of having a family meal and parental perception, associations between the family meal and health aspects (e.g., eating behaviors and diet quality) and causal influences of these associations. Descriptive data showed that mothers offer food at a structured mealtime, but that eating together as a family was not always upheld. The frequency of family meals was positively associated with more nutrient-dense food intake and a more balanced diet. Different advantages (e.g., social importance, practical considerations) and obstacles (e.g., planning, possible mess) of the family meal were mentioned by parents. Further, having structured mealtimes and family meals was associated with more food enjoyment and less fussy and emotional eating. Finally, no causal studies were identified. The limited number of studies suggests that the pattern of positive associations between family meal and child health which has been shown in older children may also exist in infants and toddlers. More specific research is needed to examine the causality of the associations between the family meal and health of the infant and toddler. The associations between the family meal and less fussiness and emotional eating, more food enjoyment and better nutrient intake suggest that the family meal is a valuable moment to promote healthy eating in toddlers and infants.