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Parenting behaviours and maternal infant feeding practices in first-time Australian mothers. Daniels L*, Jansen E, Nicholson J, Battistutta D, Kremers S, Magarey A * Institute of Health and Biomedical Innovation (IHBI), School of Public Health (SPH), Queensland University of Technology (QUT)

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Parenting behaviours and maternal infant feeding practices in first-time Australian mothers

Daniels L*, Jansen E, Nicholson J, Battistutta D, Kremers S, Magarey A

* Institute of Health and Biomedical Innovation (IHBI), School of Public Health (SPH), Queensland University of Technology (QUT)

60 Musk Ave Kelvin Grove Qld 4059, Australia | t:61 (0) 7 3138 6139 | f: 07 3138 6030 | e: l2.daniels@qut.edu.au

  • Background
  • Emerging evidence that parenting style and early feeding practices are associated with child food intake, eating behaviours and weight status (Ventura & Birch, 2008)
  • 14-17% of 2-3 year old Australian children are overweight; 4% are obese (Australian Government – Dep. Health & Ageing, 2008)
  • General parenting styles potentially provide a framework within which specific parenting and feeding practices may be executed (Gubbels et al., 2009; Rhee, 2008)
  • Unclear if a focus on quality of parenting can influence feeding practices

Aim

Examine the cross-sectional relationships between mothers’ general parenting behaviour and their infant-feeding practices and beliefs taking into account maternal and infant-related characteristics

Table 1: Characteristics of study sample

  • Methods
  • Participants
  • Enrolled in the NOURISH RCT (in 2008) (Daniels et al, 2009)
  • N = 421 mother-child dyads
  • Mothers:
  • First-time mothers; facility with English
  • > 18 years; mean age 30±5 years
  • No self report of eating or mental health problems
  • Infants:
  • Healthy term (gestational age >35 weeks, birth weight >2500g)
  • 9-22 weeks old (mean age 19±4 weeks)
  • 206 boys (48.93%)
  • Outcome measures
  • Baseline data collection for NOURISH RCT; prior to allocation
  • Self-reported
  • Parenting behaviours
    • 15 items, 3 domains:
    • - Parenting self-efficacy (4 items)
    • - Parenting warmth (6 items)
    • - Parenting irritability (5 items)
    • Validated in the Longitudinal Study of Australian Children (LSAC;
    • Australian Institute Family Studies, 2003)
  • Feeding practices and beliefs
  • Based on Infant Feeding Questionnaire (IFQ; Baughcum et al., 20010)
  • Factor structure reanalysed due to:
    • Concurrent use of IFQ rather than retrospective
    • High prevalence of breastfeeding  3 items related to bottle feeding excluded
    • Infant sample (Baughcum sample mean age 16.2±3.5 months)
    • Australian sample
  • New factor structure: 15 items, 4 factors (62% variance):
    • Concern about infant undereating or becoming underweight
    • (α =.78; 16.2% variance)
    • Concern about infant overeating or becoming overweight
    • (α =.65; 8.9% variance)
    • 3. Lack of awareness of infant’s hunger and satiety cues
    • (α =.74; 22.3% variance)
    • 4. Inflexible infant-feeding
    • (α =.75; 14.7% variance)
    • Two items were excluded because they loaded weakly onto a separate factor
  • Covariates  See Table 1 for details
  • MaternalInfant
  • BMI (measured) • Gender
  • Weight concern (Killen et al, 1994) • Weight status (birth w. & w.-gain z-score)
  • Age • Age
  • Education level • Feeding mode
  • Mother’s perception of infant’s weight status
  • Data analyses
  • Descriptive statistics
  • Multivariate regression analysis
    • 4 models: one per each infant-feeding factor
    • Parenting behaviours entered first
  • Covariates entered simultaneously for model adjustment

* N varies from 356 cases to 421 due to missing data on different variables

** UK standards

*** Mother’s concern about her own weight; Weight Concern Scale by Killen et al. (1994); range 0-5, higher scores indicate more concern

Results

Table 2: Associations of feeding practices & beliefs with parenting behaviours controlling for infant & maternal covariates (N= 356). Significant relationships only – inverse or positive.

Note: Reference groups are in italic; p < .05; cases with missing data on any independent variable or covariate were excluded; adjusted R2 reported

* Standardized β

a Dummy variable 1 for feeding mode, ‘0’ = breast feeding or combination, ‘1’ = formula feeding

b Dummy variable 1 for mother’s perceptions of her child’s weight status, ‘0’ = normal or overweight, ‘1’ = underweight

c ‘1’ = pre-tertiary level, ‘2’ = tertiary level

d Dummy variable 2 for mother’s perceptions of her child’s weight status, ‘0’ = normal or underweight, ‘1’ = overweight

e ‘1’ = underweight/normal weight, ‘2’ = overweight/obese

  • Conclusions
  • Parenting behaviours partly explained maternal feeding beliefs in the adjusted models
    • Self-efficacy was related to 3 of 4 feeding practices & beliefs
  • 4 covariates were independent predictors across multiple feeding
  • practices & belief factors
  • Maternal perception of infant’s weight status and infant’s actual weight
  • were consistent with the factors ‘concern about infant becoming overweight’ and ‘concern about infant becoming underweight’
  • Strategies to improve early feeding practices & beliefs need to be
  • cognisant of and support broader parenting approaches, particularly
  • self-efficacy and irritability
  • Longitudinal studies are needed to determine direction of relationships
  • Strengths and limitations
  • + Concurrent use of the Infant Feeding Questionnaire (Baughcum et al., 2001)
  • + Adjustment for a range of maternal & infant-related characteristics
  • Maternal self-report of feeding & parenting behaviours
  • ± Maternal BMI measured but categorization according to standard guidelines (no post-natal BMI classification available)
  • ± Applied less frequently used measurement tools as commonly used
  • instruments have not been validated in infants

References

Australian Institute Family Studies. www.aifs.gov.au/growingup/pubs.html#wave1, 2003; Baughcum et al. J Dev BehavPediatr 2001;22(6):391-408: Daniels et al. Bmc Public Health 2009;9:387; Department of Health and Ageing. Canberra, 2008; Gubbels et al. Appetite 2009;52(2):423-9; Killen et al. Int J Eat Disorder 1994;16(3):227-38; Rhee K. Ann Am Acad Polit SS 2008;615:12-37; Ventura & Birch. Int J BehavNutr Phys Act 2008;5:15