The Comprehensive Feeding Practices Questionnaire (CFPQ) measures parental attitudes towards feeding practices that directly influence children’s eating habits. This study aims to determine the reliability and validity of the Turkish adaptation of the CFPQ developed by Musher-Eizenman et al.

Validity and reliability analyses were conducted for the Turkish version of the CFPQ (T-CFPQ). In addition to reliability analyses and partial correlations between scale dimensions, correlations between scale dimensions according to mothers’ BMI and children’s BMI z-scores were also examined.

Parents with children aged 18 months to 8 years living in the community.

The study sample consisted of 274 parents with children aged 18 months to 8 years who agreed to participate in the online survey.

In this study, forty-seven items and twelve-factor structure describing feeding practices were supported by the confirmatory factor analysis. Although most of the dimensions of the T-CFPQ showed significant correlations with each other, the highest correlation was found between the encourage balance/variety and the dimension of modelling and teaching nutrition (r = 0·53; 0·50) (P < 0·05). There was a negative correlation between the child’s BMI z-score and the pressure to eat dimension (r = –0·173; P < 0·01) and a positive correlation between the restriction for weight dimension (r = 0·339; P < 0·01). Maternal BMI was negatively associated with the involvement dimension (r = –0·121; P < 0·05) and positively associated with the restriction for weight dimension (r = 0·154; P < 0·01).

The findings revealed that the T-CFPQ is a valid and reliable measurement tool that can be applied to obtain the necessary information for evaluating nutritional interactions between parent and child.

Encouraging healthy eating is a public health priority in the United Kingdom (UK), given the high prevalence of poor diet and overweight/obesity among school-aged children. Holiday clubs are organisations providing childcare and activities during the school holidays and frequently provide food to children at risk of food insecurity, primarily through government-funded programmes like the Holiday Activities and Food programme. However, the research suggests that holiday clubs could do more to maximise opportunities to promote children’s healthy eating by using evidence-based feeding practices.

During August–September 2020, video-based interviews were conducted exploring staff perceptions of the feasibility of using four evidence-based feeding practices to promote children’s healthy eating: modelling; involvement in food choice; involvement in food preparation and cooking and involvement in meal planning. Feasibility was assessed using four dimensions of a feasibility framework (acceptability, demand, practicality and implementation).

UK holiday clubs.

Twenty-five staff actively involved in delivering UK holiday clubs (project leaders, coordinators, cooks and coaches/youth workers).

Staff generally reported good acceptability (dimension 1) and demand (dimension 2) for the feeding practices. However, the practicality (dimension 3) of using the practices was dependent on various factors (logistics, resources, staff readiness, children, peers and parents). Promisingly, in the fourth feasibility dimension (implementation), staff provided numerous practical solutions to overcome these barriers.

Evidence-based feeding practices can be implemented in numerous ways and are therefore generally feasible in holiday clubs. Holiday clubs should be empowered to use evidence-based feeding practices through training resources, sharing networks and provision of sustainable funding.

To examine racial/ethnic differences in maternal feeding practices and beliefs in a sample of low-income smoke-exposed women.

Cross-sectional analysis using data collected during a randomised control trial. Maternal feeding practices and beliefs were assessed using the Infant Feeding Questionnaire (IFQ), which was administered at 6 months postpartum. ANOVA was used to examine differences in IFQ items by race/ethnicity, while multivariable linear regression models were used to examine differences in IFQ factor scores by race/ethnicity adjusting for potential confounders.

Participants were recruited from prenatal clinics.

343 women (39 % non-Hispanic White, 28 % Hispanic/Latina, 13 % Black, and 20 % other).

Racial/ethnic minority mothers were more likely than non-Hispanic White mothers to put cereal in their infant’s bottle so that the infant would stay full longer (P = 0·032), state their infant wanted more than just formula or breast milk prior to 4 months (P = 0·019), allow their infant to eat whenever he/she wanted (P = 0·023) and only allow their infant to eat at set times (P < 0·001). Adjusting for potential confounders, racial/ethnic minority mothers had higher scores for factors 1 (concern about infant undereating or becoming underweight), 2 (concern about infant’s hunger), 4 (concern about infant overeating or becoming overweight) and 5 (feeding infant on a schedule), and lower scores for factor 7 (social interaction with the infant during feeding) than White mothers. Racial/ethnic differences were not found for the other two factors.

Differences in maternal feeding practices and beliefs across race/ethnicity are present at 6 months postpartum.

To examine the mediating effects of maternal perception of child weight (weight perception) and concern about overweight (weight concern) on the paths between child weight and maternal feeding practices.

Pudong District, Shanghai, China.

A convenience sample of 1164 mothers who were primary caregivers of preschool children.

Sixty per cent of the mothers perceived their overweight/obese children as normal weight or even underweight. The disagreement between actual child weight and maternal weight perception was statistically significant (Kappa = 0·212, P < 0·001). Structural equation modelling indicated that weight perception fully mediated the relationship between child BMI Z-scores and pressure to eat. Weight concern fully mediated the relationships between child BMI Z-scores and the other three feeding practices. The serial mediating effects of weight perception and concern were statistically significant for the paths between child BMI Z-score and monitoring (β = 0·035, P < 0·001), restriction (β = 0·022, P < 0·001), and food as a reward (β = –0·017, P < 0·05).

Child weight may influence maternal feeding practices through weight perception and concern. Thus, interventions are needed to increase the accuracy of weight perception, which may influence several maternal feeding practices and thereby contribute to child health.

Feeding practices used by educators in Early Childhood Education and Care (ECEC) settings can influence the diet quality of young children. However, Australian data is scarce and limited to describing barriers to responsive feeding. This study describes the use of feeding practices amongst a group of Australian educators.

Direct observation of feeding practices and assessment of centre policy were conducted using the ‘Environment and Policy Assessment and Observation’ tool. Self-reported feeding practices and demographic data were collected via online survey using the Childcare Food and Activity Practices Questionnaire.

Ten centre-based ECEC services in South East Queensland, Australia.

Educators working in ECEC.

A total of 120 meals were observed and 88 educators provided self-report data (n 84 female). Centre policy supported the use of responsive feeding practices, and this was reflected in the high frequency with which children could decide what and how much to eat, across both observed and self-report data as well as low levels of pressure to eat and use of food as a reward (observed at 19·9 % and 0 % of meals). The only apparent discrepancy was regarding modelling. Median score for self-reported role-modelling was 5·0 (4·3–5·0) and educators were observed to sit with children at 75 % of meals, however observed occasions of enthusiastic role modelling was only 22 % (0–33·3) of meals.

Research addressing how educators conceptualise feeding practices, as well under what circumstances they are used, particularly in centres with different models of food provision, may shed light on why modelling is rarely implemented in practice.

The objectives of this study were to document feeding practices amongst rural Senegalese children aged 6 to 23 months and to investigate psychosocial and environmental factors associated with the provision of iron-rich foods (IRF).

This was a cross-sectional study conducted from January to July 2018.

The study took place in the region of Matam, northern Senegal.

Ninety-eight mothers of children aged 6–23 months.

Results show that 27·6 % of children were fed according to the minimum acceptable diet, and 55·1 % and 53·1 % had the minimum diet diversity and minimum meal frequency, respectively. About 65·3 % of mothers provided IRF to young children the day before the survey, mostly fish. Mother’s intention to provide IRF to their children was not associated with the provision of these foods neither was the perceived behavioural control. Child’s age (OR = 1·14, 95 % CI (1·03, 1·26), P = 0·012) and household food insecurity score (OR = 0·80, 95 % CI (0·68, 0·96), P = 0·014) were the predictors of the provision of IRF to children aged 6–23 months.

Household food insecurity status and age of the child rather than mothers’ psychosocial factors were significant predictors of IRF consumption amongst children aged 6–23 months in the study area. More attention should be given to food environment and child-related factors in order to improve children feeding practices and, in particular, their consumption of IRF in the study setting. For instance, home visits and the 5-month-old vaccine consultation in health centres might be opportunities to reinforce the importance of providing IRF as part of complementary foods from the age of 6 months. Implementation of measures for the improvement of socio-economic conditions and food security of households would also be valuable.

The main aim of this study was to assess the psychometric proprieties of the Child Feeding Questionnaire (CFQ) in Italian mothers.

Mothers completed the Italian version of the CFQ, and children’s anthropometric data were collected. Construct validity of the CFQ was assessed by comparing three different models: (a) a seven correlated factors model in which all items were analysed; (b) a seven correlated factors model with composite items based on the Restriction factor and (c) an eight correlated factors model with a separate Reward factor. Measurement invariance using BMI categories and gender was evaluated. Furthermore, discriminant validity with group comparison was performed between BMI categories and gender.

Italy.

A total of 1253 6-year-old Italian children (53·9 % male) attending elementary school (1st grade) and their mothers (mean age = 38·22 years; sd = 4·89) participated in this study.

The eight-factor model with a separate reward factor provided the best fit for the data. The strict invariance of the CFQ across child BMI categories and gender was confirmed. The CFQ internal consistency was acceptable for most subscales. However, two subscales showed no adequate values. As expected, the CFQ scales showed significant differences between BMI categories, while no gender-related differences were found.

The study indicated the Italian version of the CFQ to be factorially valid for assessing parental feeding practices of 6-year-old children across BMI categories. Future research should address low internal consistency in some of the CFQ subscales.

The objective was to examine the association between parenting practices, toddler’s dietary intake and BMI. In addition, potential moderation of these associations by general parenting and child temperament was examined.

The current cross-sectional study assessed parenting practices using the Comprehensive Feeding Practices Questionnaire, general parenting using the Comprehensive General Parenting Questionnaire, child temperament using the Child Behavior Check List, and children’s dietary intake through parental questionnaires. Children’s weight and length were objectively measured to determine BMI z-scores. Associations were examined using multiple linear regression analyses. Moderation was examined using interaction terms.

Home setting.

393 Dutch toddlers (age 1–3 years) and their parents recruited through fifty childcare centres and preschools in the Netherlands.

Various practices were related to children’s diet and BMI. For instance, the availability of healthy foods is the most important predictor of healthy dietary intake (e.g. β = –0·35 for sweets; β = 0·18 for fruit). The association of availability with a healthier diet was strongest when parents scored low on the positive parenting style dimensions, including nurturance, structure and/or behavioural control. In addition, it seemed that a high availability of healthy foods and low availability of unhealthy foods is especially beneficial for children showing withdrawal/depressive, anxious or overactive behaviour, while encouraging balance and variety is not beneficial for these children. All other practices were related to children’s diet and/or BMI as well.

The findings underline the importance of viewing the impact of parenting practices in the context of general parenting and child temperament.

Mexico ranks first in childhood obesity worldwide. However, little is known about the factors influencing maternal feeding practices. The present study aimed to estimate the prevalence of feeding practices and explore associations between weight concern, weight perception, sociodemographic characteristics and those feeding practices.

Cross-sectional.

North-eastern Mexico.

Mothers aged ≥18 years who were in charge of feeding a singleton child aged 2–6 years with no endocrine disease or visible genetic malformations (n 507). Information on six maternal feeding practices, concern and perception of the child’s weight and demographics were collected by interview. The mother’s and child’s height and weight were measured. The feeding practices questionnaire was subject to content, construct and convergent validity analysis. Then, mean feeding scores were obtained and prevalence and 95 % CI were determined for scores ≥3; multivariate logistic regression was performed.

Not modelling (63·5 %; 95 % CI 59·2, 67·8 %) and pressuring to eat (55·6 %; 95 % CI 51·2, 60·0 %) were the most frequent feeding practices, followed by easy access to unhealthy foods (45·4 %; 95 % CI 40·9, 49·8 %) and child control (43·2 %; 95 % CI 38·8, 47·6 %). They prevailed despite concern about the child’s excess weight or a perception of the child as overweight/obese. Education was associated with the highest number of practices (educated mothers used more pressuring to eat, less regulation and less easy access; or monitoring was less absent).

The frequency of certain feeding practices needs to be improved. Emphasis on the child’s weight concern, obesity perception and maternal education is essential for optimizing intervention planning.

We aimed to examine associations between early educators’ feeding practices and opinions and children’s dietary intake at pre-school, in a context where uniform meals are served and pre-schools are highly regulated.

Cross-sectional study. Food consumption data of the children consisted of two-day food records from pre-school kept by early educators. Early educators also reported their feeding practices and opinions on pre-school food. Serving style was observed.

Municipal pre-schools in Southern and Western Finland.

Pre-schoolers (n 586) aged 3–6 years and early educators (n 378).

Early educators’ positive opinion of the food served at pre-school and the opinion that sufficient vegetables were available for the children were positively associated with children’s vegetable consumption. Early educators’ role modelling and a positive opinion of the food were negatively associated with children’s energy intake. Encouragement to eat fruit and vegetables was associated with higher fibre intake. Intake of added sugar was low (4·4 % of energy).

Some of the feeding practices and opinions of early educators were related to healthier dietary intake (higher vegetable consumption and fibre intake) among the children. However, in some respects, the results contradicted previous findings. Overall, early educators’ feeding practices and opinions contribute to children’s dietary intake and should be taken into account when promoting healthy food intake among pre-school children.

In recent years, researchers have been working towards creating a standard conceptual framework of food parenting. To understand how parents’ reports correspond with the proposed model, the current study examined parents’ reports of their feeding behaviours in the context of a newly established framework of food parenting.

Cross-sectional, with a two-week follow-up for a subset of the sample. Participants completed a quantitative and qualitative survey to assess food parenting. The survey included items from common food parenting instruments to measure the constructs posited in the framework. Exploratory factor analyses were conducted to ascertain which items related most closely to one another and factors were mapped on to existing constructs.

Online.

Parents of children aged 2·5–7 years (n 496). Of these, 122 completed a two-week follow-up.

Analyses revealed eleven aspects of Structure (monitoring; distraction; family presence; meal/snack schedule; unstructured practices; healthy/unhealthy food availability; food preparation; healthy/unhealthy modelling; rules), ten aspects of Coercive Control (pressure to eat; using food to control emotions; food incentives to eat; food incentives to behave; non-food incentives to eat; restriction for health/weight; covert restriction; clean plate; harsh coercion) and seven aspects of Autonomy Promotion (praise; encouragement; nutrition education; child involvement; negotiation; responsive feeding; repeated offering). Content validity, assessed via parents’ open-ended explanations of their responses, was high, and test–retest reliability was moderate to high. Structure and Autonomy Promoting food parenting were highly positively correlated.

In general, parents’ responses provided support for the model, but suggested some amendments and refinements.

To describe the modification and validation of an existing instrument, the Environment and Policy Assessment and Observation (EPAO), to better capture provider feeding practices.

Modifications to the EPAO were made, validity assessed through expert review, pilot tested and then used to collect follow-up data during a two-day home visit from an ongoing cluster-randomized trial. Exploratory factor analysis investigated the underlying factor structure of the feeding practices. To test predictive validity of the factors, multilevel mixed models examined associations between factors and child’s diet quality as captured by the Healthy Eating Index-2010 (HEI-2010) score (measured via the Dietary Observation in Childcare Protocol).

Family childcare homes (FCCH) in Rhode Island and North Carolina, USA.

The modified EPAO was pilot tested with fifty-three FCCH and then used to collect data in 133 FCCH.

The final three-factor solution (‘coercive control and indulgent feeding practices’, ‘autonomy support practices’, ‘negative role modelling’) captured 43 % of total variance. In multilevel mixed models adjusted for covariates, ‘autonomy support practices’ was positively associated with children’s diet quality. A 1-unit increase in the use of ‘autonomy support practices’ was associated with a 9·4-unit increase in child HEI-2010 score (P=0·001).

Similar to the parenting literature, constructs which describe coercive controlling practices and those which describe autonomy-supportive practices emerged. Given that diets of pre-schoolers in the USA remain suboptimal, teaching childcare providers about supportive feeding practices may help improve children’s diet quality.

To assess relationships between mothers’ feeding practices (food as a reward, food for emotion regulation, modelling of healthy eating) and mothers’ willingness to purchase child-marketed foods and fruits/vegetables (F&V) requested by their children during grocery co-shopping.

Cross-sectional. Mothers completed an online survey that included questions about feeding practices and willingness (i.e. intentions) to purchase child-requested foods during grocery co-shopping. Feeding practices scores were dichotomized at the median. Foods were grouped as nutrient-poor or nutrient-dense (F&V) based on national nutrition guidelines. Regression models compared mothers with above-the-median v. at-or-below-the-median feeding practices scores on their willingness to purchase child-requested food groupings, adjusting for demographic covariates.

Participants completed an online survey generated at a public university in the USA.

Mothers (n 318) of 2- to 7-year-old children.

Mothers who scored above-the-median on using food as a reward were more willing to purchase nutrient-poor foods (β=0·60, P<0·0001), mothers who scored above-the-median on use of food for emotion regulation were more willing to purchase nutrient-poor foods (β=0·29, P<0·0031) and mothers who scored above-the-median on modelling of healthy eating were more willing to purchase nutrient-dense foods (β=0·22, P<0·001) than were mothers with at-or-below-the-median scores, adjusting for demographic covariates.

Mothers who reported using food to control children’s behaviour were more willing to purchase child-requested, nutrient-poor foods. Parental feeding practices may facilitate or limit children’s foods requested in grocery stores. Parent–child food consumer behaviours should be investigated as a route that may contribute to children’s eating patterns.