Early feeding practices and development of childhood obesity_2018_book chapter.pdf

2019-04-17T18:04:28Z (GMT) by Megan Pesch Julie Lumeng
Introduction
Early feeding practices are believed to be an
important contributor to obesity risk in early
childhood. Feeding practices can be considered
to encompass both what and how caregivers, usually
parents, feed their children. In this chapter,
we will review the evidence to support links
between feeding practices and the development
of childhood obesity. We will begin by reviewing
the evidence linking infant feeding practices and
obesity, including breastfeeding, formula composition,
the timing of introduction of solid foods,
and bottle use.
Next, we will move on to consider the evidence
for associations between parent feeding
practices in toddlerhood and beyond with child
obesity. Specifically, we will review the main
constructs typically used to conceptualize parental
feeding practices, including pressure, monitoring,
restriction, promotion of autonomy,
repeated exposure, modeling, and teaching. We
will also briefly consider the beliefs about child
obesity and feeding that often underlie these
practices. We will consider the home feeding
environment with a focus on the role of television,
family mealtimes, and timing of eating in
childhood obesity. We will consider the composition
of food served, including dietary variety.
Finally, we will consider the role of the child in
shaping the parent’s feeding behavior. Children
are not “blank slates”, but rather active participants
in the parent-child interaction around feeding.
Just as parents may shape children’s obesity
risk, children’s individual traits and behavior
shape parenting practices. We will consider children’s
food preferences, eating in the absence of
hunger, responsiveness to hunger and satiety,
emotional or stress eating, and temperament as
predictors of parent feeding practices. We will
close by considering directions for future research.
It is important to note that the vast majority of
research on this topic to date has focused on
mothers. Future work should include fathers and
father figures, as they also play critical roles in
parenting and shaping a child’s obesity risk. In
addition, much of the work on early feeding
practices has occurred in US or European populations
of children, most of whom are white and
relatively well resourced. Future work should
consider whether the findings are generalizable
to other populations of children. Finally,
understanding
feeding practices is complicated by challenges in measurement. The vast majority
of studies have gathered data via maternal self-report
on questionnaires, which has inherent bias.
A growing body of work has employed videotaped
observation, though this approach has its
own limitations. Ultimately, capturing feeding
practices requires a multi-method approach that
can consolidate, and facilitate interpretation of,
available evidence.