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Introduction: High consumption of sugar-rich foods and beverages has been associated with increased overweight and obesity in children and adolescents. Dietary behavior is influenced by learned mechanisms that originate in childhood and is associated with food parenting practices (FPP) and parental feeding styles (PFS). This systematic review aimed to narratively synthesize FPP and PFS concerning sugar-rich foods and beverages and their associations with the prospective dietary behavior of children and adolescents to derive evidence-based recommendations for health professionals and parents to promote healthy behaviors. Methods: A systematic literature search was conducted using PubMed and Web of Science databases covering the publication years 2017-2023. The results were narratively synthesized, and exposure-outcome matrices were used for visual representation. The review included 15 peer-reviewed studies from different geographical regions that investigated FPP or PFS regarding the handling of sugar-rich foods and beverages in children's diets and reported the associations with the prospective dietary behavior of children and adolescents. Results: The findings indicate that highly controlling parental practices were associated with the development of unhealthy eating behaviors and preferences for sugar-rich foods and beverages over time. Conversely, parental practices that emphasized structure and balance in dietary choices yielded more positive long-term outcomes, associated with reduced preferences for sugar-rich foods and drinks. Discussion: The results underscore the significance of fostering a healthy home environment and active parental role modeling in promoting healthier dietary behaviors among children and adolescents.

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BACKGROUND: Feeding difficulties (FDs) are complex phenomena influenced by parental factors, feeding behaviour, and cultural factors. However, studies of the influences of these factors on FDs incidence are scarce. Thus, this study aimed to identify the associations between mothers' perceptions of FDs in children and parental feeding styles, body mass index, and the consumption of fruits, vegetables and processed foods. METHOD: Two hundred and fifty-seven mothers of children aged 1 to 6 years and 11 months participated in this cross-sectional study and self-completed electronic questionnaires on sociographic variables, parental feeding styles, the consumption of fruits, vegetables and processed foods and FDs. Nutritional status was classified by body mass index (kg/m2). RESULTS: The prevalence of FDs in children was 48.2%, and the mean age was 43.8 (± 17.6) months. The indulgent parental feeding style was the most common (40.1%), followed by the authoritative (31.1%), authoritarian (23.7%), and uninvolved (5.1%) styles. An indulgent parental feeding style (OR: 4.66; 95% CI: 2.20-9.85), a high body mass index (OR: 1.35; 95% CI: 1.09-1.68), and the consumption of processed foods (OR: 5.21; 95% CI: 2.85-9.53) were positively associated with increased odds of the absence of FDs in children. The associations of authoritarian and uninvolved parental feeding styles and the consumption of fruits and vegetables with FDs in children were not significant. CONCLUSION: This study identified multiple factors that are possibly associated with feeding behaviours in young children. However, further studies need to be undertaken to evaluate how such behaviours affect FDs.

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Children in the UK do not eat enough vegetables for optimal health and development; therefore, considering methods to increase children's vegetable intake is critical. Currently, if UK children are offered vegetables to eat, this typically occurs at midday/evening meals, and/or for snacks - children are seldom offered vegetables at breakfast time, even though there is no medical, nutritional, or physiological reason not to. Therefore, this study aimed to explore the views and experiences of parents in relation to offering children (aged 18 months to four years) vegetables to eat at breakfast time. Semi-structured interviews were conducted with 18 parents (aged 27-51 years) who were asked for their opinions about offering vegetables to children at breakfast time, and about their perceptions of their child(ren)'s behaviours in relation to vegetables at breakfast. A thematic analysis of the data identified the following themes/sub-themes relating to parents' views and experiences: 1) willingness - there was widespread willingness amongst parents to offer their chid(ren) vegetables at breakfast time; 2) barriers - relating to social/behavioural norms (parent/family and societal), practical challenges, and vegetables being commonly disliked by children; 3) facilitators - relating to young children not yet having developed social norms around foods, various practical solutions, and the need for information and awareness campaigns to highlight how and why vegetables can be incorporated into children's breakfasts. These encouraging findings for optimising children's health via this novel approach suggest that further research and dissemination around the value of offering children vegetables for breakfast is required.

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Background: There are no validated instruments in Spain for measuring parental feeding styles. The aim was to validate the Parental Feeding Styles Questionnaires (PFSQ) in a Spanish sample. Method: A total of 523 mothers of 523 school-children participated. The children had a mean age of 4.4 years (SD = 1.3), with 51% being boys (M = 4.3 years, SD = 1.4) and 49% girls (M = 4.5 years, SD = 1.3). The PFSQ and the Comprehensive General Parenting Styles Questionnaire (CGPQ) were used. Results: A model of four correlated factors was identified: Prompting/encouraging eating, emotional feeding, instrumental feeding, and control over eating. Cronbach’s alpha for the subscales ranged from 0.64 to 0.86, and McDonald’s Omega coefficient ranged from 0.66 to 0.86. Emotional feeding and prompting/ encouraging eating had values above 0.70, control over eating had a value of 0.68 and instrumental feeding had an alpha coefficient of 0.64 and omega coefficient of 0.66. The factor structure was similar to the original and to other adapted versions. The Spanish sample used more control over eating and prompting/encouraging to eat. Conclusions: The adapted PFSQ is a suitable instrument for assessing the feeding styles of Spanish parents.(AU)

Antecedentes: No hay suficientes instrumentos validados en España para medir los estilos de alimentación parental. El objetivo fue validar el cuestionario de estilos de alimentación Parental (PFSQ) en muestra española. Método: Participaron 523 madres de 523 escolares con una media de edad de 4.4 años (DT = 1.3), siendo el 51% niños (M = 4.3 años, DT = 1.4) y 49% niñas (M = 4.5 años, DT=1.3). Se utilizaron el PFSQ y el cuestionario de estilos de crianza general (CGPQ). Resultados: Se identificó un modelo de cuatro factores correlacionados: persuadirle/animarle a comer, alimentación emocional, alimentación instrumental, y control de la ingesta. El alfa de Cronbach de las subescalas osciló entre 0.64 y 0.86, y el coeficiente omega de McDonald entre 0.66 y 0.86. Alimentación emocional y persuadirle/animarle a comer obtuvieron valores superiores a 0.70, control de la ingesta obtuvo 0.68 y la alimentación instrumental, un coeficiente alfa de 0.64 y un coeficiente Omega de 0.66. La estructura factorial coincide con la versión original y otras versiones adaptadas. La muestra española utilizó más el control de la ingesta y persuadirle/animarle a comer. Conclusiones: El PFSQ es un instrumento adecuado para evaluar los estilos de alimentación de los padres españoles.(AU)

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【Objective】 To explore the correlation between different feeding styles of caregivers and diet quality of children with nutritional problems, in order to provide reference for making effective feeding guidance and intervention strategy. 【Methods】 From January 2022 to August 2023, 2- to 6-year-old children who had been enrolled in kindergartens or nurseries and their caregivers from the combined outpatient department of Child Healthcare and Nutrition in Shanghai Children′s Hospital were selected into this study.The amount of dinner served and consumed was obtained through the three-day dinner intake survey, and the Chinese Healthy Eating Index (CHEI) was calculated.Feeding styles were divided into four groups through the Caregiver Feeding Style Questionnaire.Pearson correlation analysis was used to determine the correlation between served and consumed CHEI score.Chi-square test, t-test and ANOVA were used to compare the differences in CHEI score for dinner consumed in children with different feeding styles. 【Results】 1) Totally 133 parent-child pairs were included in this study.There were 68 boys (51.1%) and 65 girls (48.9%), with an average age of (4.6±0.6) years.2) CHEI scores for dinner served was highly correlated with that for dinner consumed (r=0.90, P<0.05).There was statistically significant difference between the CHEI score for dinner served and consumed by authoritative and authoritarian feeding styles (t=2.538, 1.732, P<0.05).3) After adjusting body shape, children in the authoritative feeding style actually completed a significantly higher diet quality CHEI score than those in the authoritarian feeding style (P<0.05).4)Authoritative and indulgent feeding styles had statistical differences in the distribution of children′s body size (χ2=13.587, P=0.035). 【Conclusions】 Parents with authoritarian feeding style and indulgent feeding style have worse control over their children′s dietary completion.Children with authoritative feeding style have higher dietary quality than those with authoritarian feeding style.Children with indulgent feeding style may have a higher proportion of non-low weight than those with authoritative feeding style.Although feeding style could not reverse the outcome of body shape deviation in children with disease, it may have some positive effects.

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Background: Nonresponsive feeding styles can contribute to rapid weight gain in infancy and subsequent obesity in childhood. There is a need to investigate factors such as parental mental health symptoms (stress, depression, and anxiety) that may contribute to nonresponsive feeding styles. The purpose of this study was to investigate the relationship between parental mental health symptoms and feeding styles in parents of healthy, term formula-fed infants during the first year of life. Methods: A cross-sectional, descriptive correlational design was employed using online surveys. We recruited participants through Facebook groups and pediatricians' offices. Instruments included a demographic questionnaire, the Perceived Stress Scale-10, Patient Health Questionnaire-Depression Module-9, 7-item Generalized Anxiety Disorder Assessment, and Infant Feeding Style Questionnaire. Results: Participants were 306 parents of formula-fed infants. Greater depressive symptoms was the strongest predictor of the pressuring style (ß = 0.54), while greater symptoms of stress (ß = -0.13) and anxiety (ß = -0.28) were associated with lower pressuring scores. Greater depressive symptoms was the strongest predictor of the laissez-faire style (ß = 0.48), while greater symptoms of stress (ß = -0.17) and anxiety (ß = -0.23) were associated with lower laissez-faire scores. Engaging in ≤50% of the infant's feeds was the strongest control variable predictor for the pressuring and laissez-faire styles. None of the mental health variables were significantly related to the restrictive style. Conclusions: We recommend increased screening for depressive symptoms in parents of infants and responsive feeding support, especially for those experiencing depressive symptoms.

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BACKGROUND: Parental complaints about feeding difficulties (FD) during childhood are frequent in pediatrics. Behavioral factors about children's feeding and parental aspects are fundamental in solving these problems, but research in this area lacks information considering the joint presence of fathers and mothers. Thus, this study aimed to investigate the features of children, parents and mealtime practices related to FD reported by fathers and mothers and to identify parenting styles, mealtime actions, practices and factors associated with FD in children. METHODS: 323 parents (226 mothers and 97 fathers) of children aged 1 to 7 years were recruited in the emergency waiting room at Sabará Hospital Infantil, in São Paulo, Brazil, and self-completed electronic questionnaires on parenting style (Caregiver's Feeding Styles Questionnaire), parents' mealtime actions (Parent Mealtime Action Scale), socioeconomic information, personal and children's health data and routine meal practices. RESULTS: The prevalence of FD in children was 26.6%. Indulgent parenting style was the most frequent (44.2%), followed by authoritarian (25.1%), authoritative (23.8%), and uninvolved (6.9%) styles. Most parents (75.8%) reported presence during meals, and 83.6% used distractions. Regression analyses after adjustments showed, as factors associated with FD, female children (OR: 2.06; 95%CI: 1.19-3.58), parents' FD history (OR: 3.16; 95%CI: 1.77-5.64), and greater frequency of parents' behavior of offering many food options (OR: 2.69; 95%CI: 1.18-6.14). Parents with indulgent styles had decreased chances of reporting FD in their children (OR: 0.13; 95%CI: 0.06-0.27). Furthermore, the practice of children sharing the family menu (OR: 0.43; 95%CI: 0.18-0.99) and higher frequency of parents' behavior of setting snack limits (OR: 0.44; 95%CI: 0.23-0.85) were inversely associated with FD. CONCLUSIONS: This study reinforces the multifactorial aspects involved in the feeding difficulties context. It points out the importance of expanding knowledge of the individual role of fathers and mothers to compose a scenario that can guide future studies and interventions. TRIAL REGISTRATION: CAAE #99221318.1.0000.5567 with registration number 2,961,598.

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Parents may influence children's intake of sweets and sugar-sweetened beverages through their feeding styles. This study prospectively assessed the association between parental feeding styles and caries risk in preschool children. In November and December 2021, we recruited 1181 preschool children aged 3-4 years in Guangzhou, China, and then conducted a follow-up visit after 15 months. The children were examined for dental caries, and their parents answered the Chinese version of the Parental Feeding Style Questionnaire. Data were analyzed using logistic regression analysis. At baseline, 'control over eating' was found to be negatively associated with early childhood caries (OR = 0.60, 95%CI = 0.44, 0.83). After 15 months, no significant association between baseline parental feeding styles and the risk of a new carious lesion was found. When considering changes in parental feeding styles between the baseline and the follow-up visit, we found children with increasing scores on 'instrumental feeding' during the 15 months had a higher risk of a new carious lesion (OR = 1.91, 95%CI = 1.18, 3.12). However, children with always-intermediate scores (OR = 0.51, 95%CI = 0.30, 0.86), always-high scores (OR = 0.42, 95%CI = 0.23, 0.77), or increasing scores (OR = 0.50, 95%CI = 0.31, 0.83) on 'control over eating' had a lower risk of a new carious lesion. Our study highlighted the influence of parental feeding styles on caries risk in preschool children.

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Objective: To explore whether maternal feeding styles at 12 months predict child Body Mass Index (BMI) z-scores at 72 months and evaluate whether BMI z-scores at 18 months mediates the association. Methods: Data from 239 mother-child pairs participating in a parenting intervention were analyzed. Feeding information was ascertained at 12 months by questionnaire with feeding styles identified using factor analysis. Children's weight and length/height were measured at 18 and 72 months and BMI z-scores computed. Maternal sociodemographic data, depressive symptoms and language skills were obtained by questionnaire. Multilevel linear regression analysis was used to examine whether feeding styles predicted 72 month BMI z-scores. Complete case analysis was conducted and multiple imputation used to treat missing values of explanatory and outcome variables at 18 and 72 months. Mediational analysis was performed to assess the indirect effects of feeding styles on 72 month BMI z-scores via 18 month BMI z-scores. Results: Restrictive feeding at age 12 months predicted higher 72 month BMI z-scores in both complete case analysis [ß (95%CI): 0.19 (0.02, 0.37)] and multiple imputation [ß (95%CI): 0.20 (0.02, 0.39)]. Uninvolved, forceful, indulgent and responsive feeding styles were not significant predictors of 72 month BMI z-scores. A significant indirect effect was observed between restrictive feeding and child BMI z-scores at 72 months via 18 month BMI z-scores [ß (95% CI) 0.12 (0.03, 0.22)]. Conclusion: Restrictive feeding at 12 months was associated with higher BMI z-scores at 72 months and appeared to be mediated by BMI z-scores at 18 months.

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CONTEXT: Studies on parenting, including feeding styles and practices in general, have focused mainly on mothers. Consequently, there is a gap with respect to fathers in the scientific literature. OBJECTIVE: This study's main objective is to determine paternal feeding styles toward children aged 0 to 18 years and to identify those most commonly used by men. DATA SOURCES: The PubMed, Scopus, Web of Science, Cochrane, and PsycINFO databases were consulted. DATA EXTRACTION: Articles that were not published in English, Spanish, or Italian were excluded, as well as those that referred to other subjects, those whose sample did not include men, or those studying children with pathologies that could influence their diet. All the articles ultimately included were assessed using the STROBE checklist. DATA ANALYSIS: A total of 183 articles were found. Of these, 13 were included in the review. No trend was found for paternal parenting style, and disparities existed among the authoritative, authoritarian, and permissive styles. In terms of feeding practices, men were more likely to use coercion. The most reported feeding styles were authoritarian and permissive. CONCLUSIONS: The findings of systematic review suggest cultural and gender differences exist with respect to parenting styles and feeding styles and practices. In terms of paternal parenting styles, there is some disparity. However, when it comes to feeding, men showed a tendency toward an authoritarian feeding style and coercive feeding practices.

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Family mealtimes are associated with benefits for children, including healthy eating, fewer behavior problems, and healthy psychological well-being. However, the interactions during family mealtimes, and the parent and child characteristics, which may affect both the family mealtime environment and the associated benefits in children are not fully understood. The goal of this study was to examine the role of child and parent characteristics on the family mealtime environment. We tested several mediation models to explain how child temperament (negative affectivity), parent stress, and the dimensions of parent feeding style (responsiveness and demandingness) interact and influence each other to impact the structure and quality of the mealtime environment. Parents (68 mothers; 82 fathers) of children between 2 and 6 years completed an online survey. Measures included the Children's Behavior Questionnaire, Perceived Stress Scale, Caregiver's Feeding Styles Questionnaire, and The Meals in Our Household Questionnaire. Child negative affectivity was associated with poorer mealtime quality and structure. These associations were mediated through parent responsiveness, but not demandingness. The role of demandingness in family mealtimes may depend on parent responsiveness. When examined together in a serial mediation model, child negative affectivity increased parent stress, which reduced responsiveness, and led to poorer mealtime quality and structure. These results emphasize the complex relationships between child temperament, parent stress, and the dimensions of parenting styles that occur within the mealtime context. This line of research is essential for understanding family mealtime dynamics and informing future studies aimed at creating positive interactions between parents and children during mealtimes.

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BACKGROUND: Weight outcomes have been associated with child temperament, defined as individual differences in reactivity and self-regulation. The current systematic review aims to provide an updated summary of the evidence linking temperamental negative reactivity, surgency, and regulation superfactors to early childhood feeding, eating, and weight outcomes. METHODS: PubMed, PsycINFO and Embase databases, as well as scientific meeting programs, were searched using keywords and subject headings. Publication dates were limited to 2012-2019 as prior reviews were published in 2012 and 2014. Identified studies were eligible if they included children ages 0-5 years, a measure of child temperament, and a measure of parent/caregiver feeding, child eating, or child weight. 7113 studies were identified and 121 met inclusion criteria. RESULTS: Feeding, eating, and weight outcomes were largely unrelated to overarching negative reactivity, surgency, and effortful control superfactors. Examination of individual temperament dimensions suggested difficult temperament was frequently linked to non-responsive feeding practices, whereas elevated emotionality and decreased self-regulation were linked to maladaptive eating behaviors, and lower inhibitory control to adiposity. Analyses with infants reported greater percentages of significant associations compared to children, and cross-sectional studies generally reported fewer significant associations than other study designs. CONCLUSIONS: Difficult temperament, greater emotionality and lower self-regulation and inhibitory control were the aspects of temperament most consistently related to poorer early childhood feeding, eating, and weight outcomes. Associations tended to be stronger in infancy, and when examined within a non-cross-sectional study design. Findings can inform the development of tailored efforts to promote healthy eating and growth throughout childhood.

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Chinese immigrants are a fast-growing population group in many parts of the world. Childhood obesity is increasingly a public health problem among Chinese living outside mainland China. Evidence suggests that parenting feeding styles and practices critically influence children's eating behaviors and risk of being overweight or obese. Therefore, the objectives of this review were to identify and synthesize the evidence from studies examining the associations between parenting feeding styles, feeding practices, and risk of overweight and obesity among children of Chinese parents outside mainland China. A systematic search of four electronic databases (CINAHL, Medline, PsycINFO, and PubMed) was conducted to identify peer-reviewed studies published in English between January 2000 and March 2022. Fifteen studies met the inclusion criteria and were included in the review. Findings of some of the reviewed studies showed that parenting feeding styles and practices varied according to children's age, gender, weight, and parents' acculturation levels. The two most identified parenting feeding styles were indulgent and authoritarian. Parents classified as having indulgent and/or authoritarian feeding styles reported using several feeding practices with unintended detrimental effects, such as pressuring children to eat and restricting or controlling child food intake (type and amount). Some of these feeding practices were associated with an increased risk of child overweight. The findings of this review provide important information that can inform the design interventions to address modifiable nonresponisve parental feeding practices such as pressuring, restricting, and controlling that meet the specific needs of Chinese parents and children outside mainland China.

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Although parental feeding plays an important role in child eating and weight status, high food motivation among children may also be a factor shaping how feeding impacts child weight. This study explored whether individual differences in preschool children's food motivation interacted with mothers' feeding styles in predicting subsequent child weight status. Participants included 129 Hispanic Head Start mother/child dyads. Data were collected at ages 4-5 years (Time 1) and 7-9 (Time 3). Staff measured heights/weights and observed children in an eating in the absence of hunger task. Mothers reported on feeding styles/practices and children's eating behaviors. A principal components analysis derived a measure of highly motivated eating in children. Multiple regressions predicted Time 3 child BMI z-scores. Time 3 BMI z-scores were positively predicted by authoritative and indulgent feeding styles and negatively predicted by monitoring. Since feeding style interacted with highly motivated eating, separate regressions were run for high and low food motivation in children. Unexpectedly, results showed that authoritative feeding positively predicted Time 3 child BMI z-scores only for children showing low levels of food motivation. Characterizing differential parental feeding and child eating phenotypes may assist in tailoring childhood obesity prevention programs for the target populations.

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Early childhood is a critical time of development. Caregiver feeding style, including of child care providers, has been implicated in influencing children's food preferences and obesity. A better understanding of the determinants of child care providers' feeding styles is important as children increasingly receive daily care and nutrition in child care centers. Valid instruments to measure provider feeding styles specifically for infants are needed. This study's objective was to validate, for use with child care providers, the Infant Feeding Styles Questionnaire (IFSQ), an instrument originally designed for parents of infants and toddlers. Study data came from the Baby Nutrition and Physical Activity Self-Assessment for Child Care (Baby NAP SACC) study, a cluster randomized trial, designed to evaluate the efficacy of a six-month-long obesity prevention intervention in child care centers. The IFSQ was administered at baseline and follow-up to infant and toddler teacher participants (n = 244). Scores for baseline IFSQ teacher responses (n = 219) were calculated for the 13 sub-constructs across the five feeding styles. We tested reliability with Cronbach's alpha coefficients and performed confirmatory factor analysis to examine factor loadings and goodness of fit characteristics, modifying constructs to achieve best fit. Reliability coefficients ranged from 0.42 to 0.82 for all sub-constructs. Goodness of fit indices for the final model ranged from: root mean square error of approximation (RMSEA) 0.000-0.082; comparative fit index (CFI) 0.943-1.000; Tucker-Lewis index (TLI) 0.906-1.000; and standardized root mean squared error (SRMR) 0.006-0.130. In a sample of racially diverse infant and toddler child care teachers, final models of the laissez-faire, pressuring, and responsive constructs and the restrictive-diet quality sub-construct performed well. Overall model fit was poor for the indulgence construct, but good for solely its corresponding belief items.

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BACKGROUND: Research is needed to identify pathways by which household food insecurity (FI) contributes to parental controlling feeding styles and infant food responsiveness, 2 factors that play a role in shaping obesity risk across infancy and early childhood. OBJECTIVES: This longitudinal study tested the hypothesis that prenatal FI would be positively associated with higher infant food responsiveness via greater parental mental health symptomatology and controlling feeding styles (pressuring, restrictive). METHODS: Participants included a community sample of 170 birth parents and their infants participating in an ongoing longitudinal study. Parents self-reported household FI and mental health symptoms (depression and anxiety) during pregnancy. Postnatally, parents reported their mental health symptoms, their use of controlling feeding styles, and infant food responsiveness. Path analyses with bias-corrected 95% bootstrapped CIs tested direct and indirect associations between prenatal FI and infant food responsiveness. RESULTS: Prenatal FI was indirectly associated with higher infant food responsiveness via greater parental mental health symptomatology and pressuring to finish (b = 0.01; 95% CI: 0.001, 0.025). Prenatal FI was associated with greater parental mental health symptomatology across the peripartum period (ß = 0.54; P < 0.001), which in turn was associated with more pressuring to finish at 2 months pospartum (ß = 0.29; P = 0.01) and higher infant food responsiveness at 6 months (ß = 0.17; P = 0.04). There were no direct effects of prenatal FI on controlling feedings styles or infant food responsiveness. CONCLUSIONS: Our findings point to parental mental health as a potential pathway by which FI may be associated with obesity-promoting parental feeding styles and infant appetitive behaviors. In addition to ensuring reliable access to enough quality food during pregnancy, multipronged assistance that promotes emotional well-being during the peripartum period and clinical guidance on noncontrolling feeding styles could benefit parent and infant health and well-being.

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OBJECTIVE: To investigate the moderating role of caregiver feeding styles in the association between preschool children's food-approaching eating behaviors and body mass index (BMI) z-scores. METHODS: This cross-sectional study examined 81 caregiver-preschooler dyads from low-income neighborhoods in Santiago, Chile. Moderated multiple linear regression analyses were used to determine the moderating effect of the indulgent feeding style in the relation between eating behaviors and BMI z-scores of preschool children. RESULTS: The indulgent caregiver feeding style moderated the association between food responsiveness and BMI z-scores of preschoolers. In an indulgent feeding style, food responsiveness was associated with higher child BMI z-scores (ß = 0.50; P < 0.001). There was no interaction between enjoyment of food and feeding styles in relation to children's BMI z-scores (ß = 0.17; P = 0.58). CONCLUSIONS AND IMPLICATIONS: An indulgent feeding style can be a risk factor for unhealthy weight outcomes in food responsive preschoolers, but not in those who enjoy food. Educating indulgent parents in the feeding context, and prioritizing children with food-approaching behaviors who are sensitive to external food cues may be effective for approaching childhood obesity.

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Parental controlling feeding styles and practices have been associated with greater food-approaching appetitive behaviors (i.e., food responsiveness) linked to childhood obesity. Recent longitudinal research suggests that this relationship may be reciprocal such that controlling feeding predicts child appetite and vice versa. However, to date no studies have considered these associations during infancy. The current study investigates prospective bidirectional associations between controlling feeding (restriction, pressure, and food to soothe) and infant food responsiveness. Mothers (N = 176) reported their controlling feeding and their infant's food responsiveness at infant age 2, 6, and 14 months. A 3-wave cross-lagged panel model was used to test the effect of controlling feeding at an earlier time point on infant food responsiveness at a later time point, and vice versa. Maternal controlling feeding and infant food responsiveness showed moderate stability across infancy. Net of covariates, we observed parent-driven prospective relations between pressuring feeding styles and food to soothe with infant food responsiveness. Pressuring to finish was a significant predictor of increases in food responsiveness from 2 to 6 months (p = 0.004) and pressuring with cereal was a significant predictor of increases in food responsiveness from 6 to 14 months (p = 0.02). Greater use of situational food to soothe was marginally associated with higher food responsiveness from 2 to 6 months (p = 0.07) and 6 to 14 months (p = 0.06). Prospective associations between restrictive feeding styles and infant food responsiveness were not observed. Findings point to pressuring feeding styles and food to soothe as potential early life intervention targets to prevent increases in food responsiveness in infancy. Longitudinal research with follow-up in the toddler and preschool years are needed to understand how these associations unfold over time and whether child-driven effects of food responsiveness become apparent as children get older.

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Responsive feeding is currently the recommended feeding style, in which the key principle is reciprocity between the child and the caregiver. The lack of reciprocity characterizes non-responsive feeding styles, which are associated with unhealthy eating behaviors, losses in the regulation of hunger and satiety, and childhood obesity. To assess factors associated with feeding styles between infants aged 6-12 months old, a cross-sectional study with 474 pairs of mothers and infants from 6 to 12 months old was conducted in Public Health Units in the Federal District, Brazil. The questionnaire applied to mothers evaluated four feeding styles from nine subconstructs (Infant Feeding Style Questionnaire), breastfeeding, bottle use, maternal depression and anxiety, household food insecurity (HFI), and prematurity. Multiple linear regression analysis was performed using the automated backward method. Bottle use was positively associated with feeding styles Laissez-faire (Attention) (ß:0.56), Pressuring (Cereal) (ß:0.58) and Restrictive (Quantity) (ß:0.26). Breastfeeding was negatively associated with Laissez-faire (Attention) (ß:-0.29) and Pressuring (Cereal) (ß:-0.50). Higher maternal education was negatively associated with Pressuring (Cereal) (ß:-0.34) and Pressuring (Soothing) (ß:-0.36). HFI is positively associated with Restrictive (Quantity) (ß:0.25), and Prematurity is negatively associated with Laissez-faire (Attention) (ß:-0.33). An important positive association was found between non-responsive styles and both bottle use and HFI, while breastfeeding and higher maternal education exhibited a negative association. Therefore, feeding styles and their associated factors should be considered in the design of interventions that promote a healthy diet for infants.

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The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these low-income samples, on average, were heavier than their same-aged peers across all parent feeding styles.

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