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Bottle‐fed infants are at higher risk for rapid weight gain compared with breastfed infants. Few studies have attempted to disentangle effects of feeding mode, milk composition and relevant covariates on feeding interactions and outcomes. The objective of the present study was to compare effects of breastfeeding directly at the breast versus bottle‐feeding expressed breast milk on feeding interactions. Mothers with <6‐month‐old infants (n = 47) participated in two counterbalanced, feeding observations. Mothers breastfed their infants directly from the breast during one visit (breast condition) and bottle‐fed their infants expressed breast milk during the other (bottle condition). Masked raters later coded videos using the Nursing Child Assessment Parent–Child Interaction Feeding Scale. Infant intake was assessed. Mothers self‐reported sociodemographic characteristics, infant feeding patterns (i.e. percentage of daily feedings from bottles) and level of pressuring feeding style. Mother and infant behaviours were similar during breast and bottle conditions. Percent bottle‐feeding moderated effects of condition on intake (P = 0.032): greater percent bottle‐feeding predicted greater intake during the bottle compared with breast condition. Effects of feeding mode were not moderated by parity or pressuring feeding style, but, regardless of condition, multiparous mothers fed their infants more than primiparous mothers (P = 0.028), and pressuring feeding style was positively associated with infant intake (P = 0.045). Findings from the present study do not support the hypothesis that feeding mode directly impacts dyadic interaction for predominantly breastfeeding mothers and infants, but rather suggest between‐subject differences in feeding experiences and styles predict feeding outcomes for this population.

Globally, an estimated 162 million children less than five years of age are chronically undernourished. With 44% of children under the age of 5 years being stunted, 10% wasted, and 29% underweight, Ethiopia has one of the highest malnutrition rates in sub- Saharan Africa. Inadequate dietary intake due to compromised appetite along with poor quality complementary foods that are high in fiber and low in nutrient-density may be part of the problem. The objective of the study was to investigate the effect of fiber content and responsive feeding style on the food intake of infants. A within subject cross over design was used to evaluate the effect of fiber and responsive feeding on food intake of infants. Complementary foods that are high and low in fiber were formulated. A trial among 36 mother-infant pairs (9-11 months) was investigated the food intake when high and low fiber complementary foods with and without responsive feeding were provided. Intake of LF of the infants (87.66 g) was significantly higher than HF (86.18 g). After receiving responsive feeding training, infants' intake was increased by 12.15 and 27.83% for HF and LF, respectively. Food intake decreases with increased fiber content. Responsive feeding significantly increases food intake, but the magnitude of the increase is dependent on fiber content. Applying responsive feeding and decorticating grains to decrease the fiber content is recommended to improve infants' food intake and prevent under nutrition.

Establishing healthy feeding habits during infancy is crucial for optimal growth. However, certain parental feeding and cultural practices might hinder the development of children's healthy eating behaviours. This research explored responsive feeding practices among migrant mothers in Australia. Semi‐structured telephone interviews were conducted in their native language with 20 Arabic and 20 Mongolian‐speaking migrant mothers with children under 2 years old or currently pregnant. Thematic analysis was conducted using the framework method. Both cultural groups followed a variety of feeding practices, including on demand responsive feeding or structured schedules. Arabic‐speaking mothers tended to demonstrate responsive feeding practices more frequently than Mongolian‐speaking mothers, except for those using formula feeding, who consistently followed a fixed feeding routine. When introducing solid foods, mothers from both groups often overlooked their babies' hunger and satiety cues, frequently pressuring their children to finish their entire plate. One cited reason for this was the challenge parents faced in identifying such cues. Arabic‐speaking mothers often supplemented with formula top‐ups after introducing solid foods, due to the belief that breast milk or solid foods alone might not sufficiently nourish their infants. Additionally, some Arabic‐speaking mothers used food‐based rewards to encourage eating. Mongolian mothers expressed a cultural preference for chubby babies, a potential reason why they may have been inclined to pressure‐feed their children. Moreover, both groups reported using digital devices to distract their children during meals. This study highlights the necessity of tailoring future resources and services related to responsive feeding practices to accommodate diverse literacy levels and cultural backgrounds. Responsive feeding is crucial for children's optimal development. Migrant mothers often practice nonresponsive feeding due to lack of resources, support, and guidance. Future resources should be co‐designed for diverse literacy levels and cultural backgrounds, and research should explore health care professionals' cultural competency in advising on responsive feeding practices. Key messages Arabic‐speaking mothers generally exhibited responsive feeding practices more often than Mongolian‐speaking mothers, except for those employing formula feeding who consistently adhered to a set feeding schedule. Both Arabic and Mongolian‐speaking mothers reported difficulty in identifying their babies' hunger and satiety cues, resulting in instances where they felt compelled to pressure their children to eat. Future resources and services should be co‐designed with parents to accommodate diverse literacy levels and cultural backgrounds. Future resources should also prioritise guiding mothers to identify hunger and satiety cues when feeding their infants, as well as addressing misconceptions about food, health, and body image. This includes challenging the notion that chubby babies are inherently healthier.

To examine associations between maternal characteristics and feeding styles in Caribbean mothers. Participants were mother-child pairs enrolled in a cluster randomised trial of a parenting intervention in three Caribbean islands. Maternal characteristics were obtained by questionnaires when infants were 6-8 weeks old. Items adapted from the Toddler Feeding Behaviour Questionnaire were used to assess infant feeding styles at the age of 1 year. Feeding styles were identified using factor analysis and associations with maternal characteristics assessed using multilevel linear regression. Health clinics in St. Lucia (n 9), Antigua (n 10) and Jamaica (n 20). A total of 405 mother-child pairs from the larger trial. Maternal depressive symptoms were associated with uninvolved (β = 0·38, 95 % CI (0·14, 0·62)), restrictive (β = 0·44, 95 % CI (0·19, 0·69)) and forceful (β = 0·31, 95 % CI (0·06, 0·57)) feeding and inversely associated with responsive feeding (β = -0·30, 95 % CI (-0·56, -0·05)). Maternal vocabulary was inversely associated with uninvolved (β = -0·31, 95 % CI (-0·57, -0·06)), restrictive (β = -0·30, 95 % CI (-0·56, -0·04)), indulgent (β = -0·47, 95 % CI (-0·73, -0·21)) and forceful (β = -0·54, 95 % CI (-0·81, -0·28)) feeding. Indulgent feeding was negatively associated with socio-economic status (β = -0·27, 95 % CI (-0·53, -0·00)) and was lower among mothers ≥35 years (β = -0·32, 95 % CI (-0·62, -0·02)). Breast-feeding at 1 year was associated with forceful feeding (β = 0·41, 95 % CI (0·21, 0·61)). No significant associations were found between maternal education, BMI, occupation and feeding styles. Services to identify and assist mothers with depressive symptoms may benefit infant feeding style. Interventions to promote responsive feeding may be important for less educated, younger and socio-economically disadvantaged mothers.

Early childhood obesity (ECO) significantly increased in the USA. ECO interventions lack focus on the prevention of ECO for infants under 2. Caregiver's feeding styles (CFS) have been shown to affect ECO development, but studies on CFS are limited. This study examined socio-ecological factors associated with CFS for infants under 2 in Nevada. This cross-sectional study utilising a survey examined the five CFS constructs: responsive (RP), non-responsive (NRP) Laissez-Faire, NRP pressuring, NRP restrictive and NRP indulgent. Descriptive analysis and logistic regression following a hierarchical modelling approach were used to determine the associations between the CFS constructs and socio-ecological factors (e.g. household, maternal mental health and infant feeding). Clark County, Nevada. 304 caregivers with infants under 2. NRP-feeding styles were associated with low-income households (e.g. NRP restrictive (adjusted OR (AOR) = 2·60, 95 % CI (1·01, 6·71))), water insecurity (e.g. NRP pressuring (AOR = 2·46, 95 % CI (1·00, 6·06)), young mothers (e.g. NRP-Laissez-Faire (AOR = 2·39, 95 % CI (1·00, 5·84))), lower maternal education (e.g. RP (AOR = 0·58, 95 % CI (0·33, 1·00))), mild risk for depression (e.g. NRP restrictive (AOR = 0·50, 95 % CI (0·28, 0·90))) and a moderate to severe risk for anxiety (e.g. NRP pressuring (AOR = 0·32, 95 % CI (0·14, 0·74))). There were no associations between infant-feeding factors and RP feeding. Our study identified socio-ecological factors associated with dissimilarities in CFS in Nevada. These findings can be used to tailor educational approaches to address disparities in ECO.

Parental feeding practices and styles influence child diet quality and growth. The extent to which these factors have been assessed in the context of disadvantage, particularly household food insecurity (HFI), is unknown. This is important, as interventions designed to increase responsive practices and styles may not consider the unique needs of families with HFI. To address this gap, a scoping review of studies published from 1990 to July 2021 in three electronic databases was conducted. A priori inclusion criteria were, population: families with children aged 0–5 years experiencing food insecurity and/or disadvantage; concept: parental feeding practices/behaviours/style; and context: high income countries. The search identified 12,950 unique papers, 504 full-text articles were screened and 131 met the inclusion criteria. Almost all the studies (91%) were conducted in the United States with recruitment via existing programs for families on low incomes. Only 27 papers assessed feeding practices or styles in the context of HFI. Of the eleven interventions identified, two assessed the proportion of participants who were food insecure. More research is required in families outside of the United States, with an emphasis on comprehensive and valid measures of HFI and feeding practices. Intervention design should be sensitive to factors associated with poverty, including food insecurity.

Background What, when, how, how much, and how often infants are fed have been associated with childhood obesity risk. The objective of this secondary analysis was to examine the effect of a responsive parenting (RP) intervention designed for obesity prevention on parents’ infant feeding practices in the first year after birth. Methods Primiparous mother-newborn dyads were randomized to the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study RP intervention or child safety control. Research nurses delivered intervention content at home at infant age 3–4, 16, 28, and 40 weeks, and at a research center at 1 year. RP feeding guidance advised feeding that was contingent (i.e., feed in response to hunger and satiety signs, alternatives to using food to soothe), and developmentally appropriate (i.e., delaying introduction of solids, age-appropriate portion sizes). Infant feeding practices (i.e., bottle use, introduction of solids, food to soothe) were assessed by phone interviews and online surveys and dietary intake was assessed using a food frequency questionnaire. Results RP mothers were more likely to use of structure-based feeding practices including limit-setting ( p  < 0.05) and consistent feeding routines ( p  < 0.01) at age 1 year. RP group mothers were less likely to use non-responsive feeding practices such as pressuring their infant to finish the bottle/food ( p  < 0.001), and using food to soothe ( p  < 0.01), propping the bottle ( p  < 0.05) assessed between 4 and 8 months, and putting baby to bed with a bottle at age 1 year ( p  < 0.05). Few differences were seen between groups in what specific foods or food groups infants were fed. Conclusions Anticipatory guidance on RP in feeding can prevent the use of food to soothe and promote use of more sensitive, structure-based feeding which could reduce obesity risk by affecting how and when infants are fed during the first year. Trial registration The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study. www.clinicaltrials.gov . NCT01167270. Registered 21 July 2010.

The aim of this study was to assess the extent to which specific feeding styles may be associated with the diets of infants aged 6–9 months in Guinea. This study was designed to have multiple, iterative phases with methodological triangulation. During Phase 1 of data collection, direct observations (n = 10) were used to develop a tailored tool for Phase 2, during which 72 meal observations were conducted among infants aged 6–9 months to define caregiver feeding styles. Specific behaviours underlying established feeding styles were recorded at the level of the intended bite. Following each observation, infant diet diversity scores (DDS), or the number of food groups consumed in the previous 24 h, were collected. During Phase 3, we interviewed 34 caregivers to understand the drivers of their feeding styles. Caregiver feeding styles were determined using cluster analysis of observed behaviours and a linear regression was used to explore the relationship between feeding style and infant DDS. Textual data from interviews were thematically analysed to explain the drivers of feeding style. Caregivers were characterized as those using forceful (n = 12), responsive (n = 52) or uninvolved (n = 8) feeding styles. Our study found that responsive feeding was not associated with a higher DDS when controlling for child age in months. The most salient factors shaping feeding style in this setting included perception around infant and young child developmental stage, food refusals and trust in infant cues. Overall, food insecurity may need to be addressed in addition to feeding styles to improve DDS. Summary A forceful feeding style was described being adhered to by caregivers primarily because of frequent food refusal. Caregivers who responsively fed their infants described trusting their infant's hunger and satiety cues and allocating ample time for feeding. An uninvolved feeding style was described being adpoted by caregivers who perceived their infants to be developmentally ready to feed themselves independently. Caregivers who fed their infants responsively did not feed a significantly higher DDS when controlling for infant age in months. Graphical Findings revealed three caregiver feeding styles in peri‐urban Guinea, including forceful, uninvolved, and responsive. Adhering to a responsive feeding style in our sample was not associated with a higher dietary diversity score among infants from 6–9 months. Key drivers of caregiver feeding styles were perceptions around infant developmental stage, food refusals, and trust in infant cues.

Background: Primary care offers a promising setting for promoting parenting practices that shape healthy eating and physical activity behaviors of young children. This study assessed the impact of a parent-based, primary care intervention on the feeding habits, health behaviors, and body mass index (BMI) of 2–5 year olds with elevated or rapidly-increasing BMI. Methods: Four private pediatric offices in West Michigan were assigned as control (n = 2) or intervention (n = 2) sites based on patient load and demographics. Treatment families were recruited at well-child visits to receive physician health-behavior counseling and four visits with a registered dietitian nutritionist (RDN) over a 6-month period. Intervention outcomes were age- and sex-specific BMI metrics, including BMI z-scores and percent of the 95th percentile (%BMIp95), the Family Nutrition and Physical Activity survey (FNPA), and the Feeding Practices and Structure Questionnaire (FPSQ). Results: Of 165 enrolled families, 127 completed follow-up measures (77% retention). Mean (±SD) FNPA scores improved in treatment vs. control (4.6 ± 4.6 vs. 0.1 ± 4.2; p < 0.001), and screen time (h/day) decreased (−0.9 ± 1.8 vs. 0.3 ± 1.1; p < 0.001). Non-responsive feeding practices (i.e., reward for behavior (p = 0.006) and distrust in appetite (p < 0.015)) and structure-related feeding practices (structured meal timing (p < 0.001)) improved in treatment parents vs. controls. Reductions in child BMI measures did not differ between groups. Conclusions: Families with preschool children participating in a low-intensity, primary care intervention improved obesogenic health behaviors, parent feeding habits, and child screen time, but not child adiposity. Future research should assess the sustainability of these family lifestyle improvements, and evaluate their future impact on the health and development of the children.