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.