Maternal Concern for Child Undereating_2016.pdf

ABSTRACT
OBJECTIVE: To describe features of maternal concern for her
child undereating; examine maternal and child correlates of
maternal concern for undereating; and determine whether
maternal concern for undereating is associated with feeding
practices.
METHODS: This was a cross-sectional analysis of an observational
study with 286 mother–child dyads (mean child age, 71
months). Maternal concern for undereating was assessed using
a semistructured interview. Mothers completed questionnaires
to assess picky eating, food neophobia, and feeding practices.
Feeding practices were further assessed using videotaped mealtime
observations. Logistic regression was used to assess the association
of maternal and child characteristics with maternal
concern for undereating. Regression was used to assess the association
of maternal concern for undereating with feeding
practices, controlling for covariates.
RESULTS: Over a third of mothers (36.5%) expressed concern
that their child does not eat enough. Correlates of concern for
undereating included child body mass index z-score (BMIz;
odds ratio [OR] ¼ 0.58; 95% confidence interval [CI],
0.43–0.77) and picky eating (OR ¼ 2.41; 95% CI, 1.26–4.59).
Maternal concern for undereating was associated with greater
reported pressure to eat (relative risk [RR] ¼ 1.97; 95% CI,
1.55–2.50), greater observed bribery (OR ¼ 2.63; 95% CI,
1.50–4.60), and higher observed pressure (OR ¼ 1.90; 95%
CI, 1.08–3.36) during mealtimes.
CONCLUSIONS: Mothers of children who are picky eaters and
have a lower BMIz are more likely to be concerned that their
children do not eat enough, and maternal concern for undereating
is associated with pressuring and bribing children to eat. Pediatricians
might address maternal concern for undereating by
advising feeding practices that do not involve pressure and bribery,
particularly among healthy weight children.