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Estimating and differentiating maternal feeding practices in a country ranked first in childhood obesity

  • Ana María Salinas Martínez (a1) (a2), Hid Felizardo Cordero Franco (a1) (a3), Daniela Berenice Estrada de León (a2), Gloria Estefanía Medina Franco (a1), Francisco Javier Guzmán de la Garza (a1) (a3) and Georgina Mayela Núñez Rocha (a2)...



Mexico ranks first in childhood obesity worldwide. However, little is known about the factors influencing maternal feeding practices. The present study aimed to estimate the prevalence of feeding practices and explore associations between weight concern, weight perception, sociodemographic characteristics and those feeding practices.




North-eastern Mexico.


Mothers aged ≥18 years who were in charge of feeding a singleton child aged 2–6 years with no endocrine disease or visible genetic malformations (n 507). Information on six maternal feeding practices, concern and perception of the child’s weight and demographics were collected by interview. The mother’s and child’s height and weight were measured. The feeding practices questionnaire was subject to content, construct and convergent validity analysis. Then, mean feeding scores were obtained and prevalence and 95 % CI were determined for scores ≥3; multivariate logistic regression was performed.


Not modelling (63·5 %; 95 % CI 59·2, 67·8 %) and pressuring to eat (55·6 %; 95 % CI 51·2, 60·0 %) were the most frequent feeding practices, followed by easy access to unhealthy foods (45·4 %; 95 % CI 40·9, 49·8 %) and child control (43·2 %; 95 % CI 38·8, 47·6 %). They prevailed despite concern about the child’s excess weight or a perception of the child as overweight/obese. Education was associated with the highest number of practices (educated mothers used more pressuring to eat, less regulation and less easy access; or monitoring was less absent).


The frequency of certain feeding practices needs to be improved. Emphasis on the child’s weight concern, obesity perception and maternal education is essential for optimizing intervention planning.


Corresponding author


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1. World Health Organization (2018) Report of the Commission on Ending Childhood Obesity. (accessed November 2018).
2. UNICEF (2018) Health and nutrition. (accessed November 2018).
3. Gutiérrez, JP, Rivera-Dommarco, J, Shamah-Levy, T et al. (2012) 2012 National Health and Nutrition Survey. National Results. Cuernavaca: National Institute of Public Health (in Spanish).
4. National Institute of Public Health (2012) 2012 National Health and Nutrition Survey. Results by Federal Entity, Nuevo León. Nuevo León. Cuernavaca: National Institute of Public Health (in Spanish).
5. Savage, JS, Fisher, JO & Birch, LL (2007) Parental influence on eating behavior: conception to adolescence. J Law Med Ethics 35, 2234.
6. Faith, MS, Scanlon, KS, Birch, LL et al. (2004) Parent-child feeding strategies and their relationships to child eating and weight status. Obes Res 12, 17111722.
7. Palfreyman, Z, Haycraft, E & Meyer, C (2012) Development of the parental modelling of eating behaviours scale (PARM): links with food intake among children and their mothers. Matern Child Nutr 10, 617629.
8. Arredondo, EM, Elder, JP, Ayala, GX et al. (2006) Is parenting style related to children’s healthy eating and physical activity in Latino families? Health Educ Res 21, 862871.
9. Swyden, K, Sisson, SB, Morris, AS et al. (2017) Association between maternal stress, work status, concern about child weight, and restrictive feeding practices in preschool children. Matern Child Health J 21, 13491357.
10. Haines, J, Downing, KL, Tang, L et al. (2018) Associations between maternal concern about child’s weight and related behaviours and maternal weight-related parenting practices: a cross-sectional study. Int J Behav Nutr Phys Act 15, 104.
11. Min, J, Wang, VH, Xue, H et al. (2017) Maternal perception of child overweight status and its association with weight-related parenting practices, their children’s health behaviours and weight change in China. Public Health Nutr 20, 20962103.
12. Jansen, E, Mulkens, S, Emond, Y et al. (2008) From the Garden of Eden to the land of plenty. Restriction of fruit and sweets intake leads to increased fruit and sweets consumption in children. Appetite 51, 570575.
13. Jansen, E, Mulkens, S & Jansen, A (2007) Do not eat the red food!: prohibition of snacks leads to their relatively higher consumption in children. Appetite 49, 572577.
14. Birch, LL, Fisher, JO & Davison, KK (2003) Learning to overeat: maternal use of restrictive feeding practices promotes girls’ eating in the absence of hunger. Am J Clin Nutr 78, 215220.
15. Carnell, S & Wardle, J (2007) Associations between multiple measures of parental feeding and children’s adiposity in United Kingdom preschoolers. Obesity (Silver Spring) 15, 137414.
16. Corsini, N, Danthiir, V, Kettler, L et al. (2008) Factor structure and psychometric properties of the Child Feeding Questionnaire in Australian preschool children. Appetite 51, 474481.
17. Nowicka, P, Sorjonen, K, Pietrobelli, A et al. (2014) Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive. Appetite 81, 232241.
18. de Lauzon-Guillain, B, Musher-Eizenman, D, Leporc, E et al. (2009) Parental feeding practices in the United States and in France: relationships with child’s characteristics and parent’s eating behavior. J Am Diet Assoc 109, 10641069.
19. Anderson, CB, Hughes, SO, Fisher, J et al. (2005) Cross-cultural equivalence of feeding beliefs and practices: the psychometric properties of the Child Feeding Questionnaire among Blacks and Hispanics. Prev Med 41, 521531.
20. Seth, JG, Evans, AE, Harris, KK et al. (2007) Preschooler feeding practices and beliefs. Fam Community Health 30, 257270.
21. Santos, J, Kain, J, Dominguez-Vásquez, P et al. (2009) Maternal anthropometry and feeding behavior toward preschool children: association with childhood body mass index in an observational study of Chilean families. Int J Behav Nutr Phys Act 6, 93.
22. Somaraki, M, Eli, K, Ek, A et al. (2017) Controlling feeding practices and maternal migrant background: an analysis of a multicultural sample. Public Health Nutr 20, 848858.
23. Gauthier, KI & Gance-Cleveland, B (2015) Hispanic parental perceptions of child weight in preschool-aged children: an integrated review. Child Obes 11, 549559.
24. Guendelman, S, Fernald, LC, Neufeld, LM et al. (2010) Maternal perceptions of early childhood ideal body weight differ among Mexican-origin mothers residing in Mexico compared to California. J Am Diet Assoc 110, 222229.
25. Valencia, AC, Thomson, CA, Duncan, B et al. (2016) Evaluating Latino WIC mothers’ perceptions of infant’s healthy growth: a formative assessment. Matern Child Health J 20, 525533.
26. Rosas, LG, Harley, KG, Guendelman, S et al. (2010) Maternal perception of child weight among Mexicans in California and Mexico. Matern Child Health J 14, 886894.
27. Flores-Peña, Y, Acuña-Blanco, A, Cárdenas-Villarreal, VM et al. (2017) The association between maternal perception of her child weight and maternal feeding styles. Nutr Hosp 34, 5158.
28. Xunta of Galicia & Pan-American Health Organization (2006) EpiDat 3.1. Epidemiological Analysis from Tabulated Data. (accessed November 2019).
29. Birch, LL, Fisher, JO, Grimm-Thomas, K et al. (2001) Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 36, 201210.
30. Kong, A, Vijayasiri, G, Fitzgibbon, ML et al. (2015) Confirmatory factor analysis and measurement invariance of the Child Feeding Questionnaire in low-income Hispanic and African-American mothers with preschool-age children. Appetite 90, 1622.
31. Baughcum, AE, Powers, SW, Johnson, SB et al. (2001) Maternal feeding practices and beliefs and their relationships to overweight in early childhood. J Dev Behav Pediatr 22, 391408.
32. Musher-Eizenman, DM & Holub, S (2007) Comprehensive feeding practices questionnaire: validation of a new measure of parental feeding practices. J Pediatr Psychol 32, 960972.
33. Murashima, M, Hoerr, SL, Hughes, SO et al. (2011) Confirmatory factor analysis of a questionnaire measuring control in parental feeding practices in mothers of Head Start children. Appetite 56, 594601.
34. Hughes, SO, Power, TG, Orlet Fisher, J et al. (2005) Revisiting a neglected construct: parenting styles in a child-feeding context. Appetite 44, 8392.
35. Hennessy, E, Hughes, SO, Goldberg, JP et al. (2010) Parent behavior and child weight status among a diverse group of underserved rural families. Appetite 54, 369377.
36. Pai, HL & Contento, I (2014) Parental perceptions, feeding practices, feeding styles, and level of acculturation of Chinese Americans in relation to their school-age child’s weight status. Appetite 80, 174182.
37. Ann and Robert H. Lurie Children’s Hospital of Chicago (2018) Practice-based Research Instruments. Instruments for the Prevention & Management of Childhood Obesity. Sketches for parents and guardians of children from 2–17 years old. (accessed November 2018).
38. Wardle, J, Guthrie, CA, Sanderson, S et al. (2001) Development of the Children’s Eating Behaviour Questionnaire. J Child Psychol Psychiatry 42, 963970.
39. Silva Garcia, K, Power, TG, Fisher, JO et al. (2016) Latina mothers’ influences on child appetite regulation. Appetite 103, 200207.
40. Webber, L, Hill, C, Cooke, L et al. (2010) Associations between child weight and maternal feeding styles are mediated by maternal perceptions and concerns. Eur J Clin Nutr 64, 259265.
41. World Health Organization (2009) AnthroPlus for Personal Computers Manual: Software for Assessing Growth of the World’s Children and Adolescents. Geneva: WHO; available at (accessed November 2018).
42. World Health Organization (2006) WHO Child Growth Standards: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for Height and Body Mass Index-for-Age: Methods and Development. Geneva: WHO.
43. López-Olmedo, N, Carriquiry, AL, Rodríguez-Ramírez, S et al. (2016) Usual intake of added sugars and saturated fats is high while dietary fiber is low in the Mexican population. J Nutr 146, issue 9, 1856S1865S.
44. Quah, PL, Syuhada, G, Fries, LR et al. (2018) Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population. PLoS One 13, e0203045.
45. Yee, AZ, Lwin, MO & Ho, SS (2017) The influence of parental practices on child promotive and preventive food consumption behaviors: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 14, 47.
46. Gray, WN, Janicke, DM, Wistedt, KM et al. (2010) Factors associated with parental use of restrictive feeding practices to control their children’s food intake. Appetite 55, 332337.
47. Kröller, K & Warschburger, P (2008) Associations between maternal feeding style and food intake of children with a higher risk for overweight. Appetite 51, 166172.
48. Musher-Eizenman, DR, de Lauzon-Guillain, B, Holub, SC et al. (2009) Child and parent characteristics related to parental feeding practices. A cross-cultural examination in the US and France. Appetite 52, 8995.
49. McPhie, S, Skouteris, H, McCabe, M et al. (2011) Maternal correlates of preschool child eating behaviours and body mass index: a cross-sectional study. Int J Pediatr Obes 6, 476480.
50. Northstone, K & Emmett, P (2005) Multivariate analysis of diet in children at four and seven years of age and associations with socio-demographic characteristics. Eur J Clin Nutr 59, 751760.
51. Kant, AK & Graubard, BI (2013) Family income and education were related with 30 year time trends in dietary and meal behaviors of American children and adolescents. J Nutr 143, 690700.
52. Hinnig, PF, Monteiro, JS, de Assis, MAA et al. (2018) Dietary patterns of children and adolescents from high, medium and low human development countries and associated socioeconomic factors: a systematic review. Nutrients 10, E436.
53. Haycraft, E, Karasouli, E & Meyer, C (2017) Maternal feeding practices and children’s eating behaviours: a comparison of mothers with healthy weight versus overweight/obesity. Appetite 116, 395400.
54. Olvera-Ezzell, N, Power, TG & Cousins, JH (1990) Maternal socialization of children’s eating habits: strategies used by obese Mexican-American mothers. Child Dev 61, 395400.
55. Lipowska, M, Lipowski, M, Jurek, P et al. (2018) Gender and body-fat status as predictors of parental feeding styles and children’s nutritional knowledge, eating habits and behaviours. Int J Environ Res Public Health 15, E852.
56. Gibson, EL & Cooke, L (2017) Understanding food fussiness and its implications for food choice, health, weight and interventions in young children: the impact of Professor Jane Wardle. Curr Obes Rep 6, 4656.
57. Farrow, CV, Galloway, AT & Fraser, K (2009) Sibling eating behaviours and differential child feeding practices reported by parents. Appetite 52, 307312.
58. Hafstad, GS, Abebe, DS, Torgersen, L et al. (2013) Picky eating in preschool children: the predictive role of the child’s temperament and mother’s negative affectivity. Eat Behav 14, 274277.
59. Instituto Nacional de Estadística y Geografía (2017) Encuesta Nacional de Empleo y Seguridad Social 2017 (ENESS). Microdatos. (accessed March 2019).


Estimating and differentiating maternal feeding practices in a country ranked first in childhood obesity

  • Ana María Salinas Martínez (a1) (a2), Hid Felizardo Cordero Franco (a1) (a3), Daniela Berenice Estrada de León (a2), Gloria Estefanía Medina Franco (a1), Francisco Javier Guzmán de la Garza (a1) (a3) and Georgina Mayela Núñez Rocha (a2)...


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