The role of child and parental factors on parents feeding practices in a clinical population of children with poor growth

Abstract

Failure to thrive (FTT) is a symptom of inadequate nutrition and growth. Parental feeding practices are important determinants in shaping weight and eating behaviors in children during a sensitive period of physical and cognitive development. The feeding interaction is a bidirectional relationship between the caregiver and the child and informed by different contextual factors such as family, parental and/or child characteristics. Responsive feeding has been found to promote children’s interest in feeding, as well as their awareness of hunger and satiety cues. This dissertation aims to explore parental beliefs and feeding practices in a clinical population of children with poor growth, as well as the contextual factors that influence parental feeding practices in this population. First, a systematic review and meta-analysis was conducted in order to synthesize the current literature examining association between parents’ stress and their feeding practices and/or styles, among parents of children ≤ 5 years old. Second, a clinical study with cross-sectional design was conducted among a clinical population of children with poor growth to examine the correlation between maternal concern about child weight or perceived feeding difficulties and feeding practices, and to investigate the role of child temperament and maternal mental health in a clinical population of children with poor growth. The findings from the two projects, showed that both general and parenting stress were associated with non-responsive feeding styles. Furthermore, higher maternal concern about child weight and perceived feeding difficulties were associated with less responsive feeding practices. Both child temperament and maternal mental health influenced the use of pressure feeding. Therefore, a review into current policies regarding parents’ mental health screening in a pediatric setting was conducted. The review suggests a lack of clear guidelines and recourse in order to support parents’ mental health screening in a pediatric setting. These findings provide a novel insight into the role of both the child and parents factors on parents’ beliefs and feeding practices. A better understanding of this relationship may provide pathways that could support and improve the clinical management of children with poor growth.