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Background: There is a substantial body of research on children's eating behaviours (e.g., food responsiveness and fussiness) and related constructs (e.g., eating in the absence of hunger, appetite self-regulation). This research provides a foundation for understanding children's dietary intakes and healthy eating behaviours, as well as efforts at intervention, whether in relation to food avoidance, overeating and/or trajectories to excess weight gain. The success of these efforts and their associated outcomes is dependent on the theoretical foundation and conceptual clarity of the behaviours and constructs. This, in turn contributes to the coherence and precision of the definitions and measurement of these behaviours and constructs. Limited clarity in these areas ultimately creates uncertainty around the interpretation of findings from research studies and intervention programs. At present there does not appear to be an overarching theoretical framework of children's eating behaviours and associated constructs, or for separate domains of children's eating behaviours/constructs. The main purpose of the present review was to examine the possible theoretical foundations of some of the main current questionnaire and behavioural measures of children's eating behaviours and related constructs. Methods: We reviewed the literature on the most prominent measures of children's eating behaviours for use with children aged ~ 0–12 years. We focused on the explanations and justifications for the original design of the measures and whether these included theoretical perspectives, as well as current theoretical interpretations (and difficulties) of the behaviours and constructs. Results: We found that the most commonly used measures had their foundations in relatively applied or practical concerns rather than theoretical perspectives. Conclusions: We concluded, consistent with Lumeng & Fisher (1), that although existing measures have served the field well, to advance the field as a science, and better contribute to knowledge development, increased attention should be directed to the conceptual and theoretical foundations of children's eating behaviours and related constructs. Suggestions for future directions are outlined. [ABSTRACT FROM AUTHOR]

Background: Little is known about the pathways linking parent feeding practices with appetitive traits and BMIz throughout infancy. This study examined bidirectional associations between parental feeding practices, infant appetitive traits, and infant BMIz. Methods: Parents (n = 380) of infants aged less than 6 months at baseline reported their feeding practices (using the Feeding Practices and Structure Questionnaire (FPSQ) for infants and toddlers), infant appetitive traits (using the Baby Eating Behaviour Questionnaire) and infant BMIz (parent-reported) at three timepoints (< 6 months, ~ 9 months, ~ 12 months) up to 12 months of age. Cross-lagged models examined bidirectional associations between parent feeding practices, infant appetitive traits and infant BMIz. Results: There was strong continuity across the three timepoints for maternal feeding practices, infant appetitive traits, and infant BMIz. Infant food avoidance was prospectively associated with higher parental persuasive feeding. Infant BMIz was prospectively associated with higher parent-led feeding. Parent use of food to calm was prospectively associated with lower infant BMIz, and infant BMIz was prospectively associated with higher infant food approach. Feeding on demand was prospectively associated with lower infant food approach. Conclusion: This study highlights the complex associations between parental feeding practices, infant appetitive traits and infant BMIz. The study demonstrated that both child and parent effects are important, suggesting a need for tailored programs beginning in infancy to promote and support infant appetitive traits and parent feeding practices that support healthy development. [ABSTRACT FROM AUTHOR]

The prevalence of child emotional and behavioral problems is an international problem but is higher in low‐ and middle‐income countries (LMIC) where there are often less mental health supports for families. Parenting programs can be an effective means of prevention, but must be low‐cost, scalable, and suitable for the local context. The RISE project aims to systematically adapt, implement, and evaluate a low‐cost parenting program for preventing/reducing child mental health problems in three middle‐income countries in Southeastern Europe. This small pre–post pilot study is informed by the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE‐AIM) framework and tested the feasibility of the intervention, the implementation, and evaluation procedures: Phase 1 of the three‐phase Multiphase Optimization Strategy (MOST) for program adaptation. Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program to parents of children aged 2–9 in North Macedonia, the Republic of Moldova and Romania in 2018. Parents completed assessments pre‐ and post‐program. Results demonstrated positive pre–post change for participating families (N = 140) on various outcomes including child externalizing and internalizing symptoms and parenting behavior, in all three countries, all in the expected direction. Program participation was associated with positive outcomes in participating families. Based on the experiences of this pilot study, we outline the practical implications for the successful implementation of parenting programs in the three countries that will inform our next study phases, factorial experiment, and RCT. [ABSTRACT FROM AUTHOR]

Nutritional status has clinical relevance and is a target of guidance to parents of children with cystic fibrosis (CF). Growth is routinely monitored in CF clinics but there is no standardized way of assessing appetitive behaviors or parents' perceptions of their children's appetite. Greater understanding of these factors could improve clinical guidance regarding parent feeding behaviors. We therefore aimed to assess parent perceptions of child weight, and parent reports of child appetite using the Baby Eating Behavior Questionnaire (BEBQ), in a sample of infants and toddlers with CF, compared with a community sample. We additionally assessed relationships of parent perceptions of child weight with parent feeding behaviors in the sample with CF. Anthropometric and questionnaire data were collected for 32 infants and toddlers with CF, as well as 193 infants and toddlers drawn from RESONANCE, a community cohort study. Parents perceived children with CF to be lower in weight than their actual weight, to a greater extent than was evident in the community sample. Parents who perceived their children with CF to be underweight vs. right weight reported greater slowness in eating on the BEBQ. Parents perceived children with CF to have greater slowness in eating and lower enjoyment of food, compared to parents of children in the community sample, independent of sample differences in child weight, age, and sex. Our results demonstrate the potential utility of the BEBQ in a clinical sample and suggest it may be helpful for clinicians to assess parents' perceptions of their child's weight and appetite to promote a fuller understanding of the child's nutritional status, facilitate appropriate feeding behaviors and alleviate unnecessary concerns. [ABSTRACT FROM AUTHOR]

Objective: To examine longitudinal patterns of child introduction to foods and drinks targeted for restriction by parents and associations between child intake frequency, mother's own liking, child early exposure and child liking for restricted foods and drinks at 5 years old.Design: The study involved secondary analyses of longitudinal data from mothers and children participating in the NOURISH randomised controlled trial. Patterns of descriptive data were examined, and a binary logistic regression model tested for prediction of child liking of a selection of restricted foods and drinks.Setting: Brisbane and Adelaide, Australia.Participants: Two hundred and eleven mothers and their first born 5-year-old children.Results: The proportion of children who had tried the selected restricted foods and drinks progressively increased from 14 months to 5 years old. Mothers' own high liking for both sweet and savoury restricted foods and drinks predicted child high liking for the same items at 5 years old. Child high intake frequency at 5 years old also predicted child high liking for sweet foods and drinks, but child early exposure did not predict child liking for the restricted items examined.Conclusions: These results challenge the belief that limiting children's intake of foods high in sugar, fat and/or salt will increase their liking for them. Findings instead suggest that restricting children's access to such foods may be beneficial. While further research is required, mothers should be made aware that their own food preferences may inadvertently influence their child's liking for the very foods they are trying to restrict. [ABSTRACT FROM AUTHOR]

This study examines how fathers negotiate the role of feeding with other family members, and how this both impacts and is shaped by the structure of mealtimes. Six separate focus groups. South East Queensland, Australia. Fathers (N = 27) of children aged ≤12 years employed in blue-collar occupations or service industries. Fathers' perceptions of their role in family feeding. Grounded theory. Two major themes were identified: (1) mealtime structure , reflecting various arrangements and management procedures that give ultimate shape to mealtimes; and (2) division of labor , reflecting the work required to bring about such arrangements and how this work is allocated. These themes were interrelated and harmonized to create family mealtimes. Fathers felt that labor was assigned pragmatically; designated roles around feeding within the family facilitated structured mealtimes. Fathers' roles in balancing the labor and structured mealtimes to feed the family require further research attention, particularly across different family structures, to enhance their engagement in and contribution to the family meal environment. Offering cooking programs and meal planning education to fathers may support them in their different roles and enhance efficiency. [ABSTRACT FROM AUTHOR]

Previous studies have investigated associations between individual foods or food group intake, and breastfeeding duration, age of solid introduction and food neophobia. This study aimed to investigate associations between whole dietary patterns in young children, and breastfeeding duration, age of solid introduction and food neophobia. Parents of children (N = 234) aged 1-5 years completed an online questionnaire. Dietary risk scores were calculated using the Toddler (1-3 years) or Preschool (>3-<5 years) Dietary Questionnaires which evaluates the previous week's food-group intake (scored 0-100; higher score = higher risk of poor dietary quality). Neophobia was measured using the Child Food Neophobia scale (1.0-4.0; higher score = more neophobic). Associations were investigated using multivariable linear regression, adjusting for covariates. Children (54% female, 3.0 ± 1.4 years) were from advantaged families and were breastfed until 11.8 (5.0-16.0) months, started solids at 5.6 ± 1.4 months of age, moderately neophobic (2.1 ± 0.7) and at moderate dietary risk (29.2 ± 9.2). Shorter breastfeeding duration (β = -0.21; p = 0.001) and poorer child food neophobia scores (β = 0.36; p < 0.001) were associated with higher dietary risk scores. Age of introduction to solids showed no association with dietary risk (p = 0.744). These findings suggest that in addition to breastfeeding promotion, supporting parents to manage neophobic behaviour may be important in promoting healthy eating patterns in early childhood. [ABSTRACT FROM AUTHOR]

Background Telephone helplines providing 24-h specialist-nurse contact present a source of immediate support for women encountering challenges with breastfeeding and may serve to prolong breastfeeding duration by building self-efficacy. To date there is little evidence on interaction effectiveness and still less on the relative effectiveness for women from different socio-economic backgrounds. Research Aim To establish the effect on maternal breastfeeding self-efficacy of calls made to a nurse-led parenting helpline. Methods From a corpus of calls made to the Australian Child Health Line (N = 723), those made by women presenting a breastfeeding concern as a prime issue (n = 60) were scored for breastfeeding self-efficacy at commencement and completion of recorded interactions. Analyses examined the significance and direction of change from beginning to end of calls and compared difference in change across calls originating from high and low social advantage locations. Results A significant increase in self-efficacy was found, but with low effect size. There was considerable variation among calls; 53% showed improvement, 25% showed no change and 22% showed reduction in breastfeeding self-efficacy. While most calls were made by women from socially advantaged locations, change was more positive for the small number of callers from disadvantaged locations. Conclusion The potential of nurse-led reactive telephone support is evident, but dependent on qualities of the interaction. For women living in disadvantaged locations telephone support may be of particular significance given the greater social barriers to breastfeeding they are likely to encounter. [ABSTRACT FROM AUTHOR]

Objective: The aim was to examine the relationship between caregiver's mental health (parental psychological distress, and parenting stress), dysfunctional parenting (lax or overreactive parenting), and the screen media use in understanding attention‐deficit/hyperactivity disorder (ADHD) symptoms of children within an integrated model framework. Background: Familial factors and screen use have shown to be significantly related to ADHD in children. However, theoretical models of the role of family environment, screen use, and ADHD have rarely been tested jointly, and little is known about these associations in southeastern European middle‐income countries (MICs). Method: Data from 835 primary caregivers (92% biological mother, 4% biological father, 3% grandmother or grandfather, 1% other) of children (2 to 9 years) from three MICs were analyzed using path analyses, and models were tested for generalizability across education levels and marital status using multigroup analyses. ADHD‐related symptoms were assessed with a structured clinical interview (Mini International Neuropsychiatric Interview for Children and Adolescents–Parent Version [MINI‐KID‐P]) and the Child Behavioral Checklist (CBCL). Results: Whereas screen use was directly associated with ADHD symptoms across measures, a significant indirect effect of lax parenting on attentional problems via screen use was found only for the CBCL parent report. The final models were tested using multigroup analyses across education levels and marital status with no significant differences. Conclusion: Investments in resource and capacity building for children's primary caregivers that target lax parenting and limiting of screen use may impact children's attentional problems across educational levels and married and nonmarried caregivers. [ABSTRACT FROM AUTHOR]

Background: This study examined bidirectional relationships between maternal feeding practices and child food responsiveness and satiety responsiveness from 2 to 5 years. Methods: Mothers (N = 207) reported their own feeding practices and child eating behaviours using validated questionnaires at child ages 2, 3.7, and 5 years. Cross-lagged analyses were conducted to test for bidirectional effects, adjusting for child BMI z-score (based on measured weight and height) at 14 months. Results: Eating behaviours and feeding practices showed strong continuity across the three time points. Maternal feeding practices (higher reward for behaviour [β =0.12, p = 0.025] and lower covert restriction [β = -0.14, p =0.008]) were prospectively associated with higher food responsiveness. Conversely, increased child satiety responsiveness was primarily prospectively associated with mothers' feeding practices (increased structured meal timing [β =0.11, p = 0.038], overt [β =0.14, p = 0.010] and covert restriction [β =0.11, p = 0.022]). The only exception was family meal setting, which was prospectively negatively associated with satiety responsiveness (β = -0.11, p =0.035). Conclusion: While maternal feeding practices and child satiety and food responsiveness show strong continuity between child age 2 and 5 years, maternal feeding practices appear to be associated with child food responsiveness over time. Conversely, child satiety responsiveness, but not food responsiveness, may also be associated with maternal feeding practices over time. These results are consistent with interventions that provide feeding advice to parents on how to respond appropriately to individual child eating behaviour phenotype. Trial registration: ACTRN12608000056392. Registered 29 January 2008. [ABSTRACT FROM AUTHOR]

Objective: Determine whether feeding practices across mothers and fathers are interpreted and measured with equivalent accuracy (measurement invariance) using the Feeding Practices and Structure Questionnaire-28 (FPSQ-28).Design: Cross-sectional hard-copy and online survey design; Setting: Socioeconomically disadvantaged community in Queensland, Australia.Participants: Mothers (n = 279) and fathers (n = 225) of 2- to 5-year old children.Variables Measured: Parental feeding practices were measured using the 7 multi-item factors from the FPSQ-28.Analysis: Confirmatory factor analysis (CFA) was applied to evaluate the factor structure of the FPSQ-28 among mothers and fathers from a socioeconomically disadvantaged community. Measurement invariance between mothers and fathers was examined using hierarchical multi-group CFAs.Results: The 7-factor FPSQ-28 model showed good fit and was invariant across parent gender.Conclusions and Implications: The FPSQ-28 subscales appear to be interpreted equivalently, and thus to measure the same constructs, irrespective of the gender of the parents. The questionnaire can be used to measure or compare mothers' and fathers' self-reported feeding practices and examine influence on child health outcomes. In the current sample of mothers and fathers recruited from a socioeconomically disadvantaged community, mothers used more 'covert restriction' than fathers. [ABSTRACT FROM AUTHOR]

Background: Concerns about fussy eating are common amongst parents of young children. However, studies of the long-term impact of fussy eating show mixed results with regard to adequacy of dietary intake and child growth. This may be in part because there is no accepted definition of fussy eating and studies measure the construct in different ways, commonly relying on parent perception. This longitudinal analysis explores maternal and child characteristics associated with maternal perception of her toddler as a fussy eater in early toddlerhood and subsequent use of feeding practices at 2 years. Methods: Mothers completed a self-administered questionnaire at child age 14 months, describing perception of their child as fussy/not fussy and child behaviour. Intake was assessed using a single 24-h recall and weight was measured by research staff. At child age 2 years mothers completed the validated 28-item Feeding Practices and Structure Questionnaire (FPSQ-28). Weight-for-age z-score (WAZ) was derived from WHO standards. Gram daily intake of fruit, vegetables and meat/ alternative and a dietary diversity score were determined. Maternal/child characteristics independently associated (p ≤ 0.05) with perception of child as a fussy eater were determined using logistic regression. Variables were combined in a structural equation model assessing the longitudinal relationship between child/maternal characteristics, perception of child as a fussy eater and eight FPSQ factors. Results: Mothers' (n = 330) perception of her child as a fussy eater at age 14 months, was associated with higher frequency of food refusal and lower WAZ (R² = 0.41) but not dietary intake. Maternal perception as fussy (age 14 months) was associated with four FPSQ factors at 2 years (n = 279) - Reward for Eating, Reward for Behaviour, Persuasive Feeding and Overt Restriction, χ²/df = 1.42, TLI = 0.95, CFI = 0.95, RMSEA = 0.04(0.03--0.05), PCLOSE = 0.99. Conclusions: Lower relative child weight and food refusal prompted mothers to perceive their child as fussy. These behaviours in healthy weight children most likely reflect self-regulation of energy intake and neophobia. This perception was prospectively associated with use of non-responsive feeding practices, which may increase obesity risk. Future interventions could directly address perceptions of growth and fussiness, supporting parents to understand food refusal as developmentally appropriate behaviour in healthy young children. Trial registration: ACTRN12608000056392. Registered 29 January 2008. [ABSTRACT FROM AUTHOR]

• Structure-related food parenting was related to lower child emotional overeating. • Structure-related snack parenting was associated with higher child food approach. • Sex and co-feeding did not moderate parent feeding and child eating relationships. During the COVID-19 pandemic, many mothers and fathers have spent more time at home with their children, warranting consideration of parenting practices around food during the pandemic as influences on obesogenic eating behaviors among children. Structure-related feeding practices, particularly around snacking, may be particularly challenging yet influential in the pandemic setting. Parent sex and levels of feeding-related co-operation among parents (co-feeding) are understudied potential influences on parent-child feeding relationships. We investigated relationships between structure-related parent feeding and child food approach behaviors during the COVID-19 pandemic, while considering potential moderating influences of parent sex and co-feeding levels. An online survey was completed by 318 parents (206 mothers and 112 fathers) of 2-12-year-olds who were living in states with statewide or regional lockdowns in May/June 2020 within the US. Mothers and fathers were drawn from different families, with each survey corresponding to a unique parent-child dyad. Parental stress/mental health, co-feeding (Feeding Coparenting Scale), structure-related food and snack parenting (Feeding Practices and Structure Questionnaire and Parenting around SNAcking Questionnaire), and child eating behaviors (Child Eating Behaviour Questionnaire) were assessed. Relationships of parents' structure-related food and snack parenting practices with their child's emotional overeating and food responsiveness behaviors were examined using structural equation modelling. Further, we investigated whether these relations were moderated by parent sex or level of co-feeding. Parent sex differences were seen in parental stress, mental health, and co-feeding, but not in structure-related food and snack parenting or child food approach eating behaviors. Structure-related food parenting was negatively associated with emotional overeating. However, structure-related snack parenting was positively associated with emotional overeating and food responsiveness. While regression paths varied between mothers vs. fathers, as well as by co-feeding levels, neither parent sex nor co-feeding levels significantly moderated relationships between parent feeding and child eating variables. Future studies of food and snack parenting and co-operation in relation to feeding among mothers and fathers within a familial unit may be critical to identify intervention strategies that draw on all family resources to better navigate future disruptive events such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Prospective studies and intervention evaluations that examine change over time assume that measurement tools measure the same construct at each occasion. In the area of parent-child feeding practices, longitudinal measurement properties of the questionnaires used are rarely verified. To ascertain that measured change in feeding practices reflects true change rather than change in the assessment, structure, or conceptualisation of the constructs over time, this study examined longitudinal measurement invariance of the Feeding Practices and Structure Questionnaire (FPSQ) subscales (9 constructs; 40 items) across 3 time points. Mothers participating in the NOURISH trial reported their feeding practices when children were aged 2, 3.7, and 5 years (N = 404). Confirmatory Factor Analysis (CFA) within a structural equation modelling framework was used. Comparisons of initial cross-sectional models followed by longitudinal modelling of subscales, resulted in the removal of 12 items, including two redundant or poorly performing subscales. The resulting 28-item FPSQ-28 comprised 7 multi-item subscales: Reward for Behaviour, Reward for Eating, Persuasive Feeding, Overt Restriction, Covert Restriction, Structured Meal Setting and Structured Meal Timing. All subscales showed good fit over 3 time points and each displayed at least partial scalar (thresholds equal) longitudinal measurement invariance. We recommend the use of a separate single item indicator to assess the family meal setting. This is the first study to examine longitudinal measurement invariance in a feeding practices questionnaire. Invariance was established, indicating that the subscales of the shortened FPSQ-28 can be used with mothers to validly assess change in 7 feeding constructs in samples of children aged 2-5 years of age. [ABSTRACT FROM AUTHOR]

Background: Feeding practices are commonly examined as potentially modifiable determinants of children's eating behaviours and weight status. Although a variety of questionnaires exist to assess different feeding aspects, many lack thorough reliability and validity testing. The Feeding Practices and Structure Questionnaire (FPSQ) is a tool designed to measure early feeding practices related to non-responsive feeding and structure of the meal environment. Face validity, factorial validity, internal reliability and cross-sectional correlations with children's eating behaviours have been established in mothers with 2-year-old children. The aim of the present study was to further extend the validity of the FPSQ by examining factorial, construct and predictive validity, and stability. Methods: Participants were from the NOURISH randomised controlled trial which evaluated an intervention with first-time mothers designed to promote protective feeding practices. Maternal feeding practices (FP) and child eating behaviours were assessed when children were aged 2 years and 3.7 years (n = 388). Confirmatory Factor analysis, group differences, predictive relationships, and stability were tested. Results: The original 9-factor structure was confirmed when children were aged 3.7 ± 0.3 years. Cronbach's alpha was above the recommended 0.70 cut-off for all factors except Structured Meal Timing, Over Restriction and Distrust in Appetite which were 0.58, 0.67 and 0.66 respectively. Allocated group differences reflected behaviour consistent with intervention content and all feeding practices were stable across both time points (range of r = 0.45-0.70). There was some evidence for the predictive validity of factors with 2 FP showing expected relationships, 2 FP showing expected and unexpected relationships and 5 FP showing no relationship. Conclusions: Reliability and validity was demonstrated for most subscales of the FPSQ. Future validation is warranted with culturally diverse samples and with fathers and other caregivers. The use of additional outcomes to further explore predictive validity is recommended as well as testing test-retest reliability of the questionnaire. [ABSTRACT FROM AUTHOR]

Background Early feeding practices lay the foundation for children's eating habits and weight gain. Questionnaires are available to assess parental feeding but overlapping and inconsistent items, subscales and terminology limit conceptual clarity and between study comparisons. Our aim was to consolidate a range of existing items into a parsimonious and conceptually robust questionnaire for assessing feeding practices with very young children (<3 years). Methods Data were from 462 mothers and children (age 21-27 months) from the NOURISH trial. Items from five questionnaires and two study-specific items were submitted to a priori item selection, allocation and verification, before theoretically-derived factors were tested using Confirmatory Factor Analysis. Construct validity of the new factors was examined by correlating these with child eating behaviours and weight. Results Following expert review 10 factors were specified. Of these, 9 factors (40 items) showed acceptable model fit and internal reliability (Cronbach's a: 0.61-0.89). Four factors reflected non-responsive feeding practices: 'Distrust in Appetite', 'Reward for Behaviour', 'Reward for Eating', and 'Persuasive Feeding'. Five factors reflected structure of the meal environment and limits: 'Structured Meal Setting', 'Structured Meal Timing', 'Family Meal Setting', 'Overt Restriction' and 'Covert Restriction'. Feeding practices generally showed the expected pattern of associations with child eating behaviours but none with weight. Conclusion The Feeding Practices and Structure Questionnaire (FPSQ) provides a new reliable and valid measure of parental feeding practices, specifically maternal responsiveness to children's hunger/satiety signals facilitated by routine and structure in feeding. Further validation in more diverse samples is required. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this study was to investigate the association between temperament in Australian infants aged 2–7months and feeding practices of their first-time mothers (n =698). Associations between feeding practices and beliefs (Infant Feeding Questionnaire) and infant temperament (easy-difficult continuous scale from the Short Temperament Scale for Infants) were tested using linear and binary logistic regression models adjusted for a comprehensive range of covariates. Mothers of infants with a more difficult temperament reported a lower awareness of infant cues, were more likely to use food to calm and reported high concern about overweight and underweight. The covariate maternal depression score largely mirrored these associations. Infant temperament may be an important variable to consider in future research on the prevention of childhood obesity. In practice, mothers of temperamentally difficult infants may need targeted feeding advice to minimise the adoption of undesirable feeding practices. [Copyright &y& Elsevier]

There is increasing evidence that parenting and feeding interact to influence children's eating behaviour and weight status. Interpretation of existing research is complicated by the lack of consensus in the conceptualisation and measurement of both ‘parenting’ and ‘feeding’, particularly the distinction between ‘styles’, ‘dimensions’ and ‘practices’. In addition, the lack of validated tools to concurrently assess feeding practices in infancy limits the capacity to examine the relationships between parenting and feeding in infancy and their short- and long-term influence on weight status. In this paper, we provide an overview of the constructs examined in this emerging area of research, highlight the conceptual, definitional and measurement challenges and propose a unifying model to aid design and the interpretation of intervention studies. Progress on these methodological issues will contribute to the robust evidence required to justify investment in interventions that focus on parenting and feeding in the context of child obesity prevention. [ABSTRACT FROM PUBLISHER]

The COVID-19 pandemic and public health measures to reduce its transmission have increased stress. Stress is associated with alterations in eating behavior which may be partly driven by effects on food-related motivation. To investigate effects of COVID-related stress on food motivation, we recruited adults (N = 429; 272 F, 157 M) to complete an online survey via Amazon MTurk in May 2020. Current COVID-related stress, retrospective pre-COVID stress, and motivation in relation to individualized preferred foods from five categories (sweet snacks, fruit, savory snacks, vegetables, and fast food) were assessed. Food motivation measures included willingness to wait, willingness to expend low effort [finger taps], willingness to expend high effort [jumping jacks], and willingness to pay for hypothetical delivery of the food item. Food motivation for each food type was assessed using a novel instrument designed for brief assessment of multiple aspects of food motivation across multiple food types. Participants were willing to pay the most for fast food followed by sweet snacks, and willing to wait longer for sweet snacks relative to other food types. While fast food and sweets also generated the most willingness to expend high and low effort, willingness to expend low effort for fruit was similar to that for fast food and sweets, and willingness to expend high effort for fruit was comparable to that for fast food. Participants were least willing to pay or expend low effort for vegetables. Higher COVID-related stress levels were associated with willingness to expend more effort and pay more for food items. These data collected during the pandemic demonstrate that highly processed and sweet foods have high motivating value across multiple measures of motivation, and COVID-related stress increases food motivation across food categories. Interventions to mitigate stress and target the link between stress and overeating may help to limit the effects of the COVID-19 pandemic on obesity. [ABSTRACT FROM AUTHOR]

Fathers' perceptions of feeding children are rarely considered in the literature, yet there is growing recognition of their unique contribution to the family feeding environment. This study aimed to explore fathers' perceptions, beliefs, attitudes and lived experiences of mealtime interactions with children and other family members. Fathers (N = 27) of children aged ≤12 years old were recruited from occupationally diverse workplaces and participated in six focus groups on-site at the fathers' workplaces. Using grounded theory, we show that fathers' connection to children at mealtimes influenced how they perceived and responded to child eating behaviours. Three major themes were identified in fathers' experiences of mealtime interactions: (i) valuing connection and communication; (ii) expectations and perceptions of child eating behaviours, and (iii) feeding practices used in an attempt to align their mealtime expectations to reality. Fathers' connections were informed by their mealtime goals, historical feeding interactions with their child and intergenerational transmission of cultural values. These values were communicated between father and child through verbal (e.g. conversations) and structural (e.g. being present at meals) cues. Fathers described challenging child behaviours that disrupted mealtime connections, such as food refusal or the use of digital devices. Awareness of child food preferences, distractors, time, personal or child mood, and guilt triggered fathers' adjustment of their feeding practices, often in an effort to avoid mealtime conflict. Fathers tended to describe their feeding practices within the context of mothers' feeding practices and mealtime participation. The values that underpin fathers' connection to family mealtimes can be leveraged to inform culturally-appropriate interventions that facilitate positive, shared family meals to support child health and development. [ABSTRACT FROM AUTHOR]

Explore the nature and dimensions of restrictive feeding with mothers of 6-year-olds. Semistructured interviews with mothers. Conversations were audio-recorded and transcribed verbatim. Brisbane and Adelaide, Australia. Twenty-nine mothers of 6-year-olds. Mothers' restrictive feeding practices. Qualitative thematic analysis. This study revealed 6 key themes relating to the restrictive feeding phenomenon: restriction of specific foods and drinks; restrictive feeding practices; mothers' motivation; mothers' preferences for restricted foods; patterns over time; and relationships with other controlling feeding practices. Parents' restrictive feeding practices are likely to be inherently inconsistent, with mothers reportedly varying their practices across different restricted foods, contexts, day to day, and as children age. Mothers intended to either totally restrict or restrict a food/drink in moderation, and these intentions presented qualitatively distinct characteristics across themes. Mothers commonly referred to foods/drinks restricted in moderation as treats, and their liking for these restricted foods/drinks was related to higher child access. This study provides insights into the nature and dimensions of restrictive feeding. Further research is proposed to clarify these findings and examine the effects of child access, types of restrictive feeding practices, and parent communication on child preferences for restricted foods and drinks across a range of cultural groups. [ABSTRACT FROM AUTHOR]

Familial influences on children's cigarette smoking have been established, yet little is known about whether these influences in childhood relate to offspring's smoking behavior in adolescence. Drawing on prior work showing that children's emotional and behavioral problems (i.e., internalizing and externalizing behavior problems) are influenced by both interparental and parent–child relationships, we examined whether children's emotional and behavioral problems would further predict their smoking behavior in adolescence. Two hundred and twenty‐one families were followed from early childhood (Mage = 4.05 years) to the 10‐year follow‐up. Interparental relationship adjustment and disagreement, dysfunctional parenting, and children's emotional and behavioral problems were reported by both mothers and fathers. Adolescents' self‐reported cigarette smoking status was assessed along with other demographic variables. Using structural equation modeling, the hypothesis was only supported based on mothers' reports, suggesting that early couple relationship adjustment and parenting relate to children's emotional and behavioral problems, which associate with smoking behavior in adolescence. When the hypothesized model was tested with emotional and behavioral problems separately, only behavioral problems were related to adolescent smoking for both parents. Findings from this study support models of family environment and children's behavioral problems, providing evidence of the long‐term links with adolescent cigarette smoking behaviors. Further family‐focused research and preventive work, for instance, testing the combination of partner support and parent training, are needed. [ABSTRACT FROM AUTHOR]

The most recent data from the Australian Children's Education and Care Quality Authority (ACECQA) present good news; 79% of Australia's Early Childhood Education and Care services are now meeting the National Quality Standard (NQS). Yet one in five services remain below standard. Understanding the context and characteristics of these services, and those of their workforce, and identifying features that distinguish them from services meeting the NQS are the first step in directing quality improvement supports. We compared services rated Working Towards with those Meeting or Exceeding the standard, through analysis of two discrete datasets: (1) ACECQA snapshots providing service data and (2) The Early Years Workforce Study providing data on educators and educator experience. We identified distinguishing structural characteristics and relational factors within services rated Working Towards. Based on the findings, strategic directions for bringing the last 21% of services across the line to meet the National Quality Standard are detailed. [ABSTRACT FROM AUTHOR]

• Individuals differ in early-appearing appetitive traits that influence body weight. • Appetitive traits show genetic and environmental influence, and have measurable neural correlates. • Biobehavioral susceptibility for obesity has implications for obesity intervention. Modern food environments are conducive to overeating and weight gain, but not everyone develops obesity. One reason for this may be that individuals differ in appetitive characteristics, or traits, that manifest early in life and go on to influence their behavioral susceptibility to gain and maintain excess weight. Classic studies showing that eating behavior in children can be measured by behavioral paradigms such as tests of caloric compensation and eating in the absence of hunger inspired the development and validation of psychometric instruments to assess appetitive characteristics in children and infants. A large body of evidence now suggests that food approach traits increase obesity risk, while food avoidant traits, such as satiety responsiveness, decrease obesity risk. Twin studies and genetic association studies have demonstrated that appetitive characteristics are heritable, consistent with a biological etiology. However, family environment factors are also influential, with mounting evidence suggesting that genetic and environmental risk factors interact and correlate with consequences for child eating behavior and weight. Further, neuroimaging studies are revealing that individual differences in responses to visual food cues, as well as to small tastes and larger amounts of food, across a number of brain regions involved in reward/motivation, cognitive control and other functions, may contribute to individual variation in appetitive behavior. Growing evidence also suggests that variation on psychometric measures of appetite is associated with regional differences in brain structure, and differential patterns of resting state functional connectivity. Large prospective studies beginning in infancy promise to enrich our understanding of neural and other biological underpinnings of appetite and obesity development in early life, and how the interplay between genetic and environmental factors affects appetitive systems. The biobehavioral susceptibility model of obesity development and maintenance outlined in this narrative review has implications for prevention and treatment of obesity in childhood. [ABSTRACT FROM AUTHOR]

Background: Against a background of changing family structures and socioeconomic demands in contemporary families, fathers are more actively engaged in meal preparation and feeding of their children, yet in research studies targeting improvement in nutrition and feeding practices fathers are under-represented. Among possible explanations for this bias are acceptability of research projects and accessibility to male research participants. The aims of this study were to identify (i) fathers' preferences for participation in child nutrition research and interventions and (ii) the potential to recruit fathers through their workplaces with the possibility of delivering interventions through those workplaces. Methods: This paper draws on two independent yet linked studies that explored fathers' roles in family feeding, and intervention studies aimed at supporting father's dietary knowledge and feeding practices. For Study 1 (conducted first) secondary data analysis was conducted on survey data (n = 463 fathers of preschool children) to determine preferences related to type of program, delivery mode, and location and timing. For Study 2 six focus groups and one individual interview were conducted with n = 28 fathers to determine acceptability of recruitment of fathers working in traditionally blue-collar occupations and service industries (as defined by the Australian Bureau of Statistics) and potential of intervention delivery through their workplaces. Results: Fathers were engaged in child feeding and indeed sought nutrition-related information. Fathers indicated a preference for family-focused and online delivery of interventions. Whilst potential to recruit through blue-collar workplaces was evident, participants were divided in their views about the acceptability of interventions conducted through the workplace. There was a sense of support for the logic of such interventions but the focus group participants in this study showed only modest enthusiasm for the idea. Conclusions: With limited support for the workplace as an intervention setting, further systematic exploration of technology-based intervention design and engagement is warranted. Based on findings, interventions should target a) content that is focused on the family and how to make changes at the family level, rather than the father individually; and b) online delivery, such as Apps or online video chat sessions, for convenience and to facilitate sharing of information with family members. [ABSTRACT FROM AUTHOR]

Objective To identify associations between structure-related and non-responsive feeding practices and children's eating behaviors. Design Cross-sectional online survey design. Participants Parents (n = 413) of 1- to 10-year-old children. Main Outcome Measures Parental feeding practices and child eating behaviors were measured via the validated Feeding Practices and Structure and Children's Eating Behaviour questionnaires. Analysis Associations between parental feeding practices and children's eating behaviors were tested using hierarchical multivariable linear regression models, adjusted for covariates. Results Feeding practices accounted for 28% and 21% of the variance in food fussiness and enjoyment of food, respectively ( P < .001). For all other eating behaviors the amount of variance explained by feeding practices was < 10% ( P < .001). Key findings were that more structure and less non-responsive practices were associated with lower food fussiness and higher enjoyment of food. Conclusions and Implications Overall, the findings suggested that mealtime structure and responsive feeding are associated with more desirable eating behaviors. Contrary to predictions, there was no evidence to indicate that these practices are associated with better self-regulation of energy intake. Longitudinal research and intervention studies are needed to confirm the importance of these feeding practices for children's eating behaviors and weight outcomes. [ABSTRACT FROM AUTHOR]

Objective: To characterise parent presentations of fussy eating and mealtime interactions at a point of crisis, through analyses of real-time recordings of calls to a parenting helpline.Design: Qualitative analysis included an inductive thematic approach to examine clinical parent presentations of fussy eating and derive underlying themes relating to mealtime interactions.Setting: Calls made to the Child Health Line regarding feeding concerns were recorded and transcribed verbatim.Subjects: From a corpus of 723 calls made during a 4-week period in 2009, twelve were from parents of children aged 6-48 months.Results: Parents of infants (≤12 months, n 6) presented feeding concerns as learning challenges in the process of transitioning from a milk-based to a solid-based diet, while parents of toddlers (13-48 months, n 6) presented emotional accounts of feeding as an intractable problem. Parents presented their child's eating behaviour as a battle (conflict), in which their children's agency over limited intake and variety of foods (child control) was constructed as 'bad' or 'wrong'. Escalating parent anxiety (parent concern) had evoked parent non-responsive feeding practices or provision of foods the child preferred.Conclusions: Real-time descriptions of young children's fussy eating at a time of crisis that initiated parents' call for help have captured the highly charged emotional underpinnings of mealtime interactions associated with fussy eating. Importantly, they show the child's emerging assertion of food autonomy can escalate parents' emotional distress that, in the short term, initiates non-responsive feeding practices. The current study identifies the importance of educational and emotional support for parents across the period of introducing solids. [ABSTRACT FROM AUTHOR]

To examine the sources and timing of advice formula feeding parents receive and how this and other factors influence the choice of formula product and formula preparation. Components of a cross-sectional survey. A child and family health service in New South Wales, Australia. Parents (n = 153) who were fully or partially formula feeding infants aged 0–6 months and who visited the service's facilities or its social media site. Type of formula, preparation of formula, and use and sources of formula feeding advice. Descriptive statistics, Mann-Whitney U or Pearson's chi-square tests, and inductive content analysis. The most common source of formula feeding advice was the formula tin/packet (96.6%). Although 79.2% received advice from a health professional, only 18.9% reported receiving this advice before using formula. Approximately half (48.0%) of the parents chose a standard cow's milk-based formula. The most common reason for their choice of formula type/brand was a personal recommendation (53.0%). Parents' responses indicated that nearly half (46.3%) incorrectly prepared the formula. Although health professional advice was widely received, this was rarely before starting formula. Despite the current national infant feeding regulations, parents who were not exclusively breastfeeding their infants did not always receive timely, health professional advice about formula feeding. [ABSTRACT FROM AUTHOR]

Over the last decade, there have been repeated calls to expand the operationalisation of food parenting practices. The conceptualisation and measurement of these practices has been based primarily on research with parent-child dyads. One unexplored dimension of food parenting pertains to the evaluation of practices specific to feeding siblings. This study describes the development and validation of the Feeding Siblings Questionnaire (FSQ) – a tool designed to measure practices in which siblings are positioned as mediators in parents' attempts to prompt or persuade a child to eat. Item development was guided by a conceptual model derived from mixed-methods research and refined through expert reviews and cognitive interviews. These interviews were conducted in two phases, where parents responded to the questionnaire primarily to test i) the readability and relevance of each item, and ii) its overall feasibility. The instrument was completed by 330 parents (96.1% mothers) in Australia with two children aged 2–5 years, and repeated by 133 parents (40.3%) two weeks later. Exploratory factor analysis was performed on baseline data. Internal consistency and test re-test reliability of the subsequent subscales were examined. Construct validity was assessed through comparisons with existing measures of food parenting practices and child eating behaviours. The final FSQ scale included 22 items, reflecting five food parenting practices: sibling competitiveness, active sibling influence, threatening unequal division of food, sibling role modelling, and vicarious operant conditioning. Internal consistency and test re-test reliability estimates were high, and there was some evidence of convergent construct validity. While its factor structure should be confirmed in a different sample, the FSQ offers a novel tool for assessing, monitoring, and evaluating feeding interactions beyond those confined to the parent-child dyad. [ABSTRACT FROM AUTHOR]

Parents' food-related and general parenting behaviors may vary according to cultural background, with consequences for child eating behavior and weight. A better understanding of food-related and general parenting behaviors adopted by Chinese-American parents, and the relationships of all of these behaviors with child weight, is essential to aid the development of culturally appropriate interventions to prevent obesity in Chinese-American children. We investigated cross-sectional relationships of acculturation with parental feeding behaviors assessed with the Child Feeding Questionnaire, Parent Feeding Styles Questionnaire and Caregiver's Feeding Styles Questionnaire, and general parenting behaviors assessed with the Parenting Styles and Dimensions Questionnaire, in a sample of Chinese-American parents of 5-12 year-old children (n = 233). Parental level of acculturation was assessed using the Suinn-Lew Asian Self-Identity Acculturation scale. We performed generalized linear regressions to explore associations of acculturation levels with parental feeding and general parenting subscales and also associations of these factors with child body mass index (BMI) z-score. Acculturation was associated with higher scores on Responsiveness in feeding, lower scores on subscales assessing controlling feeding behaviors (Restriction, Pressure to eat, Demandingness in feeding), lower scores on non-nutritive feeding behaviors (Emotional feeding, Instrumental feeding), and greater likelihood of an indulgent feeding style. With regard to general parenting, acculturation was associated with lower scores on subscales assessing authoritarian parenting. Parental Prompting/Encouragement to eat was associated with lower child BMI z-score, while authoritarian parenting subscales were associated with higher BMI z-score. An appreciation of the impact of cultural variation on food-related and general parenting may help to inform the development of culturally-sensitive obesity prevention interventions. [ABSTRACT FROM AUTHOR]

Summary: Background: Child food intake and appetitive behaviors show an inconsistent pattern of associations with parental feeding practices. Relationships likely vary depending on parent feeding style, and on the method by which child eating behaviors are measured. Objectives: We tested relationships of controlling and less controlling forms of parental promotion and limitation of eating with food intake and appetitive behaviors assessed in preschoolers' normal school environments. Methods: As part of a 5‐day protocol, preschoolers consumed standardized lunches, and caloric compensation, eating rate and eating in the absence of hunger were assessed. Feeding practices were measured using the Child Feeding Questionnaire (CFQ) and Parent Feeding Styles Questionnaire (PFSQ). CFQ‐Pressure to eat and CFQ‐Restriction were controlling forms of promotion/limitation of child intake, and CFQ‐Monitoring and PFSQ‐Prompting to eat were less controlling forms. Results: Children (3–5y, n = 70) of parents with higher CFQ‐Pressure to eat scores showed lower total intake, consuming significantly fewer calories from bread, snacks and fruits and vegetables. Higher PFSQ‐Prompting to eat was associated with lower fruit and vegetable intake only. CFQ‐Restriction and CFQ‐Monitoring scores were unassociated with food intake. Higher CFQ‐Pressure to eat was associated with slower eating rate, while higher CFQ‐Monitoring was associated with lower intake in absence of hunger. Conclusions: Parental promotion and limitation of intake were associated with preschoolers' eating behaviors assessed in an ecologically valid setting, without parents present. Controlling and less controlling forms showed differential patterns of associations. Results were consistent with child‐to‐parent and parent‐to‐child effects, but research using longitudinal designs is needed to test bidirectional relationships. [ABSTRACT FROM AUTHOR]

Child mental health problems continue to be a major global concern, especially in low- and middle-income countries (LMICs). Parenting interventions have been shown to be effective for reducing child behavior problems in high-income countries, with emerging evidence supporting similar effects in LMICs. However, there remain substantial barriers to scaling up evidence-based interventions due to limited human and financial resources in such countries. This protocol is for a multi-center cluster randomized factorial trial of an evidence-based parenting intervention, Parenting for Lifelong Health for Young Children, for families with children ages 2–9 years with subclinical levels of behavior problems in three Southeastern European countries, Republic of Moldova, North Macedonia, and Romania (8 conditions, 48 clusters, 864 families, 108 per condition). The trial will test three intervention components: length (5 vs. 10 sessions), engagement (basic vs. enhanced package), and fidelity (on-demand vs. structured supervision). Primary outcomes are child aggressive behavior, dysfunctional parenting, and positive parenting. Analyses will examine the main effect and cost-effectiveness of each component, as well as potential interaction effects between components, in order to identify the most optimal combination of program components. This study is the first factorial experiment of a parenting program in LMICs. Findings will inform the subsequent testing of the optimized program in a multisite randomized controlled trial in 2021. Trial registration: NCT03865485 registered in ClinicalTrials.gov on March 5, 2019. [ABSTRACT FROM AUTHOR]

Internationally, professionalization has become a key policy strategy targeting quality improvement in early childhood education and care (ECEC), utilizing top-down managerial strategies including implementation of quality standards and increased workforce qualifications. Set against this backdrop, this study explored educators’ accounts of their professional status and professionalism in their work. Data were collected from a representative sample of Australian educators (n = 98) participating in a national ECEC workforce study. Educator accounts were inductively and deductively coded, while statistical analysis examined association of codes with educator personal and professional characteristics. Educators overwhelmingly named their work as a profession, with three categories of explanation: purpose (educating children), qualification, and public opinions. However, analysis of educator accounts of their work practices, drawing on Moss’s (2006) understandings of the ECEC workforce, found that less than half of the educators presented their roles as other than technical or nurturing/laboring. Degree qualified teachers were more likely than less qualified educators to define professionalization in terms of purpose and professionalism in terms of autonomous decisions based on expert knowledge. Policy or practice: The study provides grassroots perspectives on professionalization and professionalism in ECEC and draws attention to three areas of misalignment between current policy and educators’ views and practices that require attention. [ABSTRACT FROM AUTHOR]

Maternal depression is a known risk factor for poor outcomes for children. Pathways to these poor outcomes relate to reduced maternal responsiveness or sensitivity to the child. Impaired responsiveness potentially impacts the feeding relationship and thus may be a risk factor for inappropriate feeding practices. The aim of this study was to examine the longitudinal relationships between self‐reported maternal post‐natal depressive symptoms at child age 4 months and feeding practices at child age 2 years in a community sample. Participants were Australian first‐time mothers allocated to the control group of the NOURISH randomized controlled trial when infants were 4 months old. Complete data from 211 mothers (of 346 allocated) followed up when their children were 2 years of age (51% girls) were available for analysis. The relationship between Edinburgh Postnatal Depression Scale (EPDS) score (child age 4 months) and child feeding practices (child age 2 years) was tested using hierarchical linear regression analysis adjusted for maternal and child characteristics. Higher EPDS score was associated with less responsive feeding practices at child age 2 years: greater pressure [β = 0.18, 95% confidence interval (CI): 0.04–0.32, P = 0.01], restriction (β = 0.14, 95% CI: 0.001–0.28, P = 0.05), instrumental (β = 0.14, 95% CI: 0.005–0.27, P = 0.04) and emotional (β = 0.15, 95% CI: 0.01–0.29, P = 0.03) feeding practices (ΔR2 values: 0.02–0.03, P < 0.05). This study provides evidence for the proposed link between maternal post‐natal depressive symptoms and lower responsiveness in child feeding. These findings suggest that the provision of support to mothers experiencing some levels of depressive symptomatology in the early post‐natal period may improve responsiveness in the child feeding relationship. [ABSTRACT FROM AUTHOR]

Establishing healthy eating habits early in life is one important strategy to combat childhood obesity. Given that early maternal child feeding practices have been linked to child food intake and weight, identifying the maternal correlates of maternal child feeding practices is important in order to understand the determinants of childhood obesity; this was the overall aim of the current review. Academic databases were searched for studies examining the relationship between maternal child feeding practices and parenting, personal characteristics and psychopathology of mothers with preschoolers. Papers were limited to those published in English, between January 2000 and June 2012. Only studies with mothers of normally developing children between the ages of 2 and 6 years were included. There were no restrictions regarding the inclusion of maternal nationality or socioeconomic status ( SES). Seventeen eligible studies were sourced. Information on the aim, sample, measures and findings of these was summarised into tables. The findings of this review support a relationship between maternal controlling parenting, general and eating psychopathology, and SES and maternal child feeding practices. The main methodological issues of the studies reviewed included inconsistency in measures of maternal variables across studies and cross-sectional designs. We conclude that the maternal correlates associated with maternal child feeding practices are complex, and the pathways by which maternal correlates impact these feeding practices require further investigation. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is a complex behaviour relying on a combination of individual mother and infant characteristics, health systems, and family, community and professional support. Optimal breastfeeding in high-income countries is particularly low. Despite having similar sociocultural backgrounds, breastfeeding rates between Ireland, the United Kingdom (UK) and Australia vary, thus there is a need to understand whether this is due to individual, sociocultural or policy differences. This research identifies the between-country differences in infant feeding mode and examines if country differences in feeding mode persist once known individual, behavioural and structural factors are considered using socioecological and person-context models. Methods: Participants were adult women with at least one infant less than 6 months of age, who completed an online survey (n = 2047) that was distributed by social media in June 2016. Within-country differences in infant feeding mode ('any breastfeeding' vs. 'no breastfeeding') were examined first before hierarchical multivariable logistic regression was used to determine if country differences in feeding mode persisted after adjusting for known factors associated with breastfeeding. Results: In this sample, 'any breastfeeding' rates were 89, 71 and 72% in Australia, Ireland and the United Kingdom respectively. Within-country differences were evident in Australia, Ireland and the UK. Four factors showed no association with infant feeding mode in Australia while they did in the other countries (maternal age, income, skin-to-skin contact, support from friends and family). Two factors were unique to Australia: the odds of being in the 'no breastfeeding' group increased when the baby was delivered via caesarean and when not enough breastfeeding information was available after birth. One determinant was unique to Ireland: the odds of being in the 'no breastfeeding' group increased when respondents indicated they were not religious; in the UK this occurred when respondents were living in a town/village. After adjusting for sets of known factors of infant feeding mode based on socioecological and person-context models, country differences remained in hierarchical regressions: the odds of not breastfeeding were higher in both Ireland (AOR 3.3, 95%CI 1.8,6.1) and the United Kingdom (AOR 2.7, 95%CI 1.5, 4.7) compared to Australia. Conclusions: This study indicates that different levels in the socioecological system are related to infant feeding behaviours. An adequate inter-systems level response would consider the interactions within and between behavioural and structural mechanisms which support breastfeeding behaviour. Optimising infant feeding practices will require an integrated web of interventions that go beyond the individual and focus on addressing factors that will influence families within their communities as they move between systems. [ABSTRACT FROM AUTHOR]

Fussy eating is a nuanced, mealtime-specific behaviour associated with difficult temperament but has been rarely examined within the context of mealtime structure. The aim of this study was to a) examine associations between child temperament, and mothers' and fathers' structure-related feeding practices and b) explore whether these associations were mediated by child fussy eating. Cohabiting mother-father pairs (N = 205) of children aged between 2- to 5-years residing in a socioeconomically disadvantaged Australian city completed self-reported, validated measures of child temperament, food fussiness and structure-related feeding practices (structured meal timing, structured meal setting and family meal setting). Child temperament was associated with maternal and paternal structure-related feeding practices, such that more difficult temperament was associated with less mealtime structure. Mothers' perception of child food fussiness mediated the relationship between difficult temperament and increased provision of alternative meals to the child from the rest of the family. Additionally, mothers' and fathers' perception of child food fussiness mediated the relationship between difficult child temperament and lower frequency of sitting at a table together for family meals. Therefore, perceptions of child food fussiness may explain why mothers and fathers use less structure at mealtimes with children who have more difficult temperaments. These results suggests that similar intervention approaches can be used for both mothers and fathers from socioeconomically disadvantaged families to target fussy eating and structure the mealtime environment. Promoting mealtime structure to facilitate parents' appropriate responses to food refusal or difficult behaviour at mealtimes is indicated. [ABSTRACT FROM AUTHOR]

Both genetic and environmental influences underpin complex multidimensional associations between maternal and child eating behaviours, maternal feeding practices and child obesity risk. The aim of the present study was to explore cross-sectional relationships between maternal and child eating behaviours, and to examine whether maternal feeding practices mediate these relationships. Data were available from 478 Australian mothers (M = 38.8 years, SD = 5.6) of a 5-10 year old child (M = 7.0 years, SD = 1.1; 48.2% male). Mothers completed an online survey that included validated measures of maternal eating behaviours, maternal feeding practices and child eating behaviours. Maternal emotional overeating and food responsiveness, were each positively associated with the parallel child eating behaviour (r = 0.29 and r = 0.21, ps < .001, respectively). Mediation analyses showed that both the relationship between maternal and child emotional overeating and between maternal and child food responsiveness, were partially mediated by use of food as a reward and overt restriction (total indirect effect: .04, 95% CI 0.02, 0.07 and 0.82, 95% CI 0.04, 0.13, respectively). Findings suggest a role for feeding practices in explaining the concordance between maternal and child eating behaviours. Moreover, the results highlight the need for interventions that support parents to recognise these eating behaviours in themselves and their children and understand how these may potentially influence the feeding practices they use. Future longitudinal research that confirms the cross-sectional relationships between maternal and child eating behaviours and feeding practices reported here will strengthen the evidence to support the importance of feeding practices in the development of dietary intake patterns and obesity risk. [ABSTRACT FROM AUTHOR]