Maternal Concern for Child Undereating_2016.pdf

ABSTRACTOBJECTIVE: To describe features of maternal concern for herchild undereating; examine maternal and child correlates ofmaternal concern for undereating; and determine whethermaternal concern for undereating is associated with feedingpractices.METHODS: This was a cross-sectional analysis of an observationalstudy with 286 mother–child dyads (mean child age, 71months). Maternal concern for undereating was assessed usinga semistructured interview. Mothers completed questionnairesto assess picky eating, food neophobia, and feeding practices.Feeding practices were further assessed using videotaped mealtimeobservations. Logistic regression was used to assess the associationof maternal and child characteristics with maternalconcern for undereating. Regression was used to assess the associationof maternal concern for undereating with feedingpractices, controlling for covariates.RESULTS: Over a third of mothers (36.5%) expressed concernthat their child does not eat enough. Correlates of concern forundereating 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 greaterreported 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 andhave a lower BMIz are more likely to be concerned that theirchildren do not eat enough, and maternal concern for undereatingis associated with pressuring and bribing children to eat. Pediatriciansmight address maternal concern for undereating byadvising feeding practices that do not involve pressure and bribery,particularly among healthy weight children.