Early feeding practices and development of childhood obesity_2018_book chapter.pdf

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