Mediating effect of maternal feeding behavior on the relationship between maternal feeding anxiety and growth and development of infants

WANG Xue; LI Zhihui; KONG Yan; YU Guiling

doi:10.11852/zgetbjzz2024-0255

PDF(679 KB)

Chinese Journal of Child Health Care ›› 2024, Vol. 32 ›› Issue (8) : 918-923. DOI: 10.11852/zgetbjzz2024-0255

Mediating effect of maternal feeding behavior on the relationship between maternal feeding anxiety and growth and development of infants

WANG Xue¹, LI Zhihui², KONG Yan², YU Guiling²

Author information +

History +

Abstract

Objective To analyze the association between maternal feeding anxiety, feeding behavior, and weight-for-length Z score (WLZ) of infants, so as to provide reference for the development of effective intervention strategies to improve maternal feeding anxiety and behavior. Methods By convenient sampling method,331 infants and their mothers from the Child Health Care Department a Grade-A tertiary hospital in Qingdao, Shandong Province were selected as the study subjects in September 2023. Maternal Feeding Anxiety Scale, Parents' Feeding Practice Scale were used as assessment tools, and infant physical indicators were used to investigate. The association between variables was analyzed by Pearson correlation, and the mediating effect was tested by the Bootstrap program software. Results The score of maternal feeding anxiety was (39.592±8.173). Positive correlations were found between feeding behaviors and maternal feeding anxiety, including pressuring to eat, concerning about infant underfeeding, emotional and instrumental feeding, and parent-led eating (r＝0.591, 0.650, 0.398, 0.317, P<0.01), which were also positively correlated with infants' WLZ (r＝0.512, 0.428, 0.218, 0.258, P<0.01). Maternal feeding anxiety was positively correlated with infant's WLZ (r＝0.442, P<0.01). Pressuring to eat, concerning about infant underfeeding, and parent-led eating all played a partial mediating role between maternal feeding anxiety and infants' WLZ, and the mediation effect values were 0.272, 0.191 and 0.050 (50.8%, 35.7% and 9.3% of the total effect), respectively. Conclusions Maternal feeding anxiety can directly affect infants' WLZ, or indirectly influence infants' WLZ through practices like pressuring to eat, concerning about infant underfeeding, and parent-led eating. In order to improve the growth and development status of infants, feeding behavior of mothers should be improved at beginning. Medical staff should provide personalized guidance based on the maternal feeding anxiety level to promote the long-term healthy development of infants.

Key words

mother / feeding anxiety / feeding behavior / infant / growth and development / weight-for-length Z score / mediating effect

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

WANG Xue, LI Zhihui, KONG Yan, YU Guiling. Mediating effect of maternal feeding behavior on the relationship between maternal feeding anxiety and growth and development of infants[J]. Chinese Journal of Child Health Care. 2024, 32(8): 918-923 https://doi.org/10.11852/zgetbjzz2024-0255

References

[1] 中国居民营养与慢性病状况报告(2020年)[J].营养学报,2020,42(6):521.
Report on nutrition and chronic diseases in China (2020)[J]. Acta Nutr Sinica, 2020,42(6): 521. (in Chinese)
[2] Hale I, Fergus T, Buhler H, et al. Raise (raising infants to be smart eaters) pilot study[J]. Child Obes, 2023, 19(1):25-33.
[3] Killion KE, Corcoran A, Romo-Palafox MJ, et al. Responsive feeding practices to promote healthy diets: A mixed method study among low-income caregivers with toddlers[J]. Nu-trients, 2024, 16(6):863.
[4] 安美静,刘西瑶,龙超,等.顺应喂养相关行为与婴幼儿饮食行为关系的研究进展[J].中华实用儿科临床杂志,2023,38(4):309-312.
An MJ, Liu XY, Long C, et al. Research progress on the association between responsive feeding practices and infant and toddler's eating behavior[J]. Chin J Appl Pediatr, 2023,38(4): 309-312. (in Chinese)
[5] Bo HX, Yang Y, Chen J, et al. Prevalence of depressive symptoms among pregnant and postpartum women in china during the COVID-19 pandemic[J]. Psychosom Med, 2021, 83(4):345-350.
[6] 李慧,张远,朱凌燕,等.0～1岁婴儿母亲喂养焦虑情绪的影响因素研究[J].现代预防医学,2021,48(2):249-252.
Li H, Zhang Y, Zhu LY, et al. Analysis of risk factors for postpartum feeding anxiety[J]. Modern Preventive Medicine, 2021,48(2): 249-252. (in Chinese)
[7] Chen TL, Chen YY, Lin CL, et al. Responsive feeding, infant growth, and postpartum depressive symptoms during 3 months postpartum[J]. Nutrients, 2020, 12(6):1766.
[8] 廖晨帆,蔡正杰,冷芳群,等.四川省偏远农村地区母亲负性情绪与6月龄内婴儿喂养方式的关系[J].中国医学科学院学报,2023,45(4):541-548.
Liao CF, Cai ZJ, Leng FQ, et al. Relationship between maternal negative emotions and feeding patterns of infants aged 0-6 months in remote rural areas of Sichuan Province[J]. Acta Academiae Medicinae Sinicae, 2023,45(4): 541-548. (in Chinese)
[9] Bergmeier H, Paxton SJ, Milgrom J, et al. Early mother-child dyadic pathways to childhood obesity risk: A conceptual model[J]. Appetite, 2020, 144:104459.
[10] 李永进.母亲喂养焦虑评价量表编制[C].营养与糖尿病并发症——达能营养中心第十六届学术会议, 2013:4.
[11] 谢丽惠.婴幼儿家长喂养行为量表编制及评价[D].北京:首都儿科研究所,2017.
Xie LH. Development and evaluation of Parents' Feeding Practice Scale for Infant and Young Child[D]. Beijing:Capital Institute of Pediatrics, 2017. (in Chinese)
[12] Pedroso J, Gubert MB. Cross-cultural adaptation and validation of the Infant Feeding Style Questionnaire in Brazil[J].PLoS One, 2021, 16(9):e0257991.
[13] Baughcum AE, Powers SW, Johnson SB, et al. Maternal feeding practices and beliefs and their relationships to overweight in early childhood[J]. J Dev Behav Pediatr, 2001, 22(6):391-408.
[14] Birch LL, Fisher JO, Grimm-Thomas K, et al. Confirmatory factor analysis of the Child Feeding Questionnaire:A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness[J]. Appetite, 2001, 36(3):201-210.
[15] Musher-Eizenman D, Holub S. Comprehensive Feeding Practices Questionnaire:Validation of a new measure of parental feeding practices[J]. J Pediatr Psychol, 2007, 32(8):960-972.
[16] Ma JQ, Zhou LL, Hu YQ, et al. Association between feeding practices and weight status in young children[J]. BMC Pediatr, 2015, 15:97.
[17] 安美静,刘西瑶,龙超,等.婴幼儿顺应喂养评估工具研究进展[J].中国儿童保健杂志,2021,29(10):1100-1104.
An MJ, Liu XY, Long C, et al. Research progress on the assessment tools of responsive feeding among infants and toddlers[J]. Chin J Child Health Care, 2021,29(10): 1100-1104. (in Chinese)
[18] Johnson W, Vazir S, Fernandez-Rao S,et al. Using the WHO 2006 child growth standard to assess the growth and nutritional status of rural south Indian infants[J]. Ann Hum Biol, 2012, 39(2):91-101.
[19] 张曦美,王海燕,马洁,等.不同喂养方式下0～12月龄婴幼儿体格发育及营养状况研究[J].中国乳品工业,2022,50(9):10-14.
Zhang XM, Wang HY, Ma J, et al. Effects of different feeding methods on physical development and nutritional status of infants aged 0-12 months[J]. China Dairy Industry, 2022,50(9): 10-14. (in Chinese)
[20] Sun J, Zhu Y, Li Y, et al. Maternal postpartum feeding anxiety was associated with infant feeding practices: Results from the mother-infant cohort study of China[J]. BMC Pregnancy Childbirth, 2020, 20(1):780.
[21] 汪之顼.婴幼儿辅食添加的新理念[J].中国儿童保健杂志,2024,32(4):362-367.
Wang ZX. New concepts of complementary feeding in infants and toddlers[J]. Chin J Child Health Care, 2024,32(4): 362-367. (in Chinese)
[22] Almaatani D, Cory E, Gardner J, et al. Child and maternal factors associated with feeding practices in children with poor growth[J]. Nutrients, 2023, 15(22):4850.
[23] 王圆媛,张学宁,刘艳.江苏省婴幼儿照护人营养知识知晓现状及影响因素[J].现代预防医学,2023,50(11):1998-2002.
Wang YY, Zhang XN, Liu Y. Infant caregivers' nutrition knowledge status and influencing factors in Jiangsu Province[J]. Modern Preventive Medicine, 2023,50(11): 1998-2002.(in Chinese)
[24] 邵祥龙,秦存,鹿文英,等.剖宫产分娩与学龄儿童超重和肥胖的相关性[J].中国妇幼保健,2021,36(20):4792-4795.
Shao XL, Qin C, Lu WY, et al. Correlation between cesarean section and overweight and obesity in school-age children[J]. Maternal and Child Health Care of China, 2021,36(20): 4792-4795. (in Chinese)
[25] 李岩.生命早期影响因素与婴幼儿生长发育的相关性研究[D].沈阳:中国医科大学,2023.
Li Y. A study on the correlation between the influencing factors in early life and infants' the growth and development [D]. Shenyang:China Medical University, 2023. (in Chinese)
[26] Haycraft E. Mental health symptoms are related to mothers' use of controlling and responsive child feeding practices: A replication and extension study[J]. Appetite, 2020, 147:104523.
[27] 夏浩业,刘坦,朱一民,等.446名产妇喂养焦虑与喂养相关行为的关联研究[J].中国生育健康杂志,2018,29(1):1-4,11.
Xia HY, Liu T, Zhu YM, et al. Study on correlation between feeding anxiety and feeding behaviors of 446 postpartum women[J]. Chin J Reproductive Health, 2018,29(1): 1-4,11. (in Chinese)
[28] 吴薇岚,江蕙芸,罗宇阳,等.家庭喂养方式和父母负性情绪与儿童营养不良发生的相关性[J].中国儿童保健杂志,2022,30(1):25-29.
Wu WL, Jiang HY, Luo YY, et al. Relationship between family feeding patterns, parents' negative emotions and child malnutrition[J]. Chin J Child Health, 2022,30(1): 25-29. (in Chinese)
[29] 万梓豪.深圳市某区学龄前儿童家长对子女体重感知与喂养行为现况及干预研究[D].武汉:华中科技大学,2021.
Wan ZH. A cross-sectional and intervention study on weight perception and feeding behaviors among parents of preschool children in a district, Shenzhen[D]. Wuhan:Huazhong University of Science and Technology, 2021. (in Chinese)
[30] Wright AS, Tulloch-Reid MK, Chang SM, et al. Maternal characteristics influence infant feeding styles in Caribbean women[J]. Public Health Nutr, 2021, 24(18):6034-6045.
[31] Trude ACB, Black MM,Surkan PJ, et al. Maternal anxiety and diet quality among mothers and toddlers from low-income households[J]. Matern Child Nutr, 2020, 16(4):e12992.
[32] Eagleton SG, Shriver LH, Buehler C, et al. Longitudinal associations among food insecurity during pregnancy, parental mental health symptoms, controlling feeding styles, and infant food responsiveness[J]. JNutr, 2023, 152(12):2659-2668.
[33] Markides BR, Laws R, Hesketh K, et al. A thematic cluster analysis of parents' online discussions about fussy eating[J]. Matern Child Nutr, 2022, 18(2):e13316.