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Maternal depressive symptom trajectories and associations with child feeding

BMC Public Health volume 24, Article number: 1636 (2024) Cite this article

Abstract

Background

Responsive feeding, when caregivers attend to children’s signals of hunger and satiation and respond in an emotionally supportive and developmentally appropriate way, is associated with the development of healthy eating behaviors, improved diet quality, and healthy weight status for children. However, gaps in the literature remain on how factors, such as maternal depressive symptoms and child temperament, influence feeding interactions.

Methods

This longitudinal secondary data analysis explored the association between maternal depressive symptom trajectory and child temperament with maternal feeding practices in women with obesity who participated in a prenatal lifestyle intervention trial. Mothers self-reported depressive symptoms at baseline, 35 weeks gestation, and 6, 12, and 18 months postpartum. At 18- and 24-months postpartum, mothers completed self-reported assessments of feeding practices and child temperament and completed in-home video-recorded meals with their child, coded using the Responsiveness to Child Feeding Cues Scale. We used group-based trajectory modeling to identify distinct trajectories of depressive symptoms and generalized regressions to assess the association between symptom trajectory group and feeding. We also explored interactions between depressive symptoms and child temperament.

Results

Three distinct trajectories of depressive symptoms were identified: No-Minimal and Decreasing, Mild-Moderate and Stable, and Moderate-Severe and Stable. At 18-months, when compared to the No-Minimal and Decreasing group, membership in the Moderate-Severe and Stable group was associated with higher observed responsiveness to child satiation cues (\(B\) =2.3, 95%CI = 0.2, 4.4) and lower self-reported pressure to eat (\(B\)=-0.4, 95%CI= -0.7, 0.0). When compared to the No-Minimal and Decreasing group, membership in the Mild-Moderate and Stable group was associated with higher self-reported restriction (\(B\) =0.4, 95%CI = 0.0,0.7). The associations between trajectory group membership and feeding practices did not reach statistical significance at 24 months. Associations between depressive symptoms and restriction were moderated by child effortful control at 18 months \((B=0.2, 95\% CI (0.0, 04)\)) and surgency at 24 months \(B=-0.3, 95\% CI (-0.6, 0.0)\)).

Conclusion

A Moderate-Severe and Stable depressive symptom trajectory was associated with more responsive feeding practices and a Mild-Moderate and Stable trajectory was associated with higher restrictive feeding. Preliminary evidence suggests that depressive symptoms impact mothers’ ability to match their use of restriction to the temperamental needs of their child.

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Background

Fostering healthy eating behaviors early in childhood is a public health priority as food preferences and eating behaviors are established early in life and track into adulthood, influencing the development of obesity and diet-related diseases [1,2,3]. As children grow, their eating behaviors are shaped by the environment in which caregivers socialize their children around food [4,5,6,7,8,9,10,11]. Caregivers influence the feeding environment through their own emotions and behaviors, which are considered to fall along two dimensions, how responsive they are to their child and how demanding/directive they are when guiding their child’s behavior [12]. A feeding environment in which caregivers encourage child autonomy in eating while providing appropriate structure around food and mealtimes is associated with the development of healthy eating behaviors [13]. For example, caregivers can help children self-regulate eating in response to physiological feelings of hunger and satiation by attuning to children’s behavioral cues indicative of hunger and satiation [14,15,16,17]. Conversely, a feeding environment in which either the caregiver or child exerts excessive control may impair the development of self-regulation. For example, if caregivers attempt to control children’s eating behaviors by pressuring their children to eat or overtly restricting foods, their children may be more likely to develop problematic eating behaviors, have poor diet quality, and have higher weight status [16, 18,19,20,21]. Similarly, if a child has more control than is appropriate given their development and unique temperament, they may be more likely to consume a low-quality diet, consume larger portion sizes, and have higher weight status [22,23,24,25]. The establishment of a mutually responsive feeding relationship in which caregivers recognize their child’s cues and respond in an emotionally supportive manner that is contingent on the child’s cues/behavior, developmentally appropriate, and predictable is critical in supporting the development of healthy eating behaviors [1]. However, gaps in the literature remain on which factors influence caregivers’ different feeding behaviors.

One caregiver-level factor suggested to influence the use of supportive feeding behaviors and healthy child weight status is maternal depression [14, 26, 27]. Symptoms of depression, such as loss of interest or pleasure, low energy, and impaired cognitive ability can impact a mother’s ability to recognize, interpret, and appropriately respond to cues from their child during feeding. For example, mothers with depressive symptoms may be unable to recognize their child’s satiation cues which can be subtle (e.g., gaze aversion) or misinterpreted as unrelated to the feeding occasion (e.g., playing with food or increased interest in surroundings) [28]. Mothers may also struggle to engage with their child at meals to guide their eating behaviors, leading them to rely on strategies that require fewer cognitive and emotional resources such as taking control through pressure or restriction or disengaging from the feeding occasion entirely [29]. Additionally, depressive symptoms could impact a mothers’ ability to adjust the feeding environment or parenting strategies contingent on the individual and developmental needs of the child [14]. Several studies have provided support for these hypotheses, finding that maternal depressive symptoms are associated with decreased awareness of hunger and satiation cues and greater use of pressure to eat and restriction [30,31,32]. However, the evidence for this relationship is mixed; most studies have been cross-sectional and have relied solely on self-report of feeding behaviors [27, 33, 34].

One explanation for inconsistent associations is that the nature of maternal depression matters. For example, Marshall et al. found in a sample of Latino farmworker families that both mothers who had chronic depressive symptoms and those with episodic but severe depressive symptoms exhibited less responsive feeding practices, and their children were more likely to develop obesity at a two-year follow-up [35]. This is concerning because less supportive feeding during this critical developmental window could have a lasting impact on children’s eating behaviors. Understanding the nature of maternal depression over time and how it impacts early child feeding is particularly important in women with obesity, who are at increased risk of experiencing peri and postpartum depression, and who are more likely to have a child that develops obesity [36, 37].

Therefore, the objective of this analysis was to identify depressive symptom trajectories of women with obesity who participated in a prenatal lifestyle intervention trial to prevent excessive weight gain during pregnancy and assess the association between trajectories and feeding. We hypothesized that there would be heterogeneity in the trajectories of depressive symptoms across mothers in this study and that trajectories that were persistently high or increasing in depressive symptoms would be associated with less responsive observed and self-reported feeding behaviors.

Methods

Sample

This was a secondary analysis of data from the Healthy Beginnings/ Comienzos Saludables (HB/CS) study [38, 39]. HB/CS was a controlled trial in which pregnant women were randomized to either a multicomponent intervention to reduce excess weight gain in pregnancy or a control group that received usual prenatal care. The study was conducted at two sites, California Polytechnic State University in San Luis Obispo, CA and The Miriam Hospital in Providence, RI. The HB/CS prenatal lifestyle intervention ended during pregnancy and resulted in a significant reduction in gestational weight gain but had no significant effect on mother or child weight from birth through 12 months [38]. HB/CS completed data collection in May 2016.

Mothers who participated in and completed the HB/CS study (n = 264) were invited to participate in Mealtime for Toddlers (MTT), an observational cohort assessing feeding interactions and child weight status [39]. MTT exclusion criteria for child participants were chronic health conditions that could affect feeding or growth, significant food allergies or dietary restrictions that could significantly affect food provided and/or the feeding interaction, a diagnosed psychiatric condition or significant developmental delay that could affect the feeding interaction or participation in the study. Interested mothers attended an orientation in which study procedures were described and written consent was obtained (n = 163). Families completed one-week assessments when the child was 18 months and 24 months old during which participating mothers completed study questionnaires, dyads were asked to have a dinner or evening meal video recorded in their homes, and dyads were also weighed and measured for length/height. A final assessment was completed at 36 months during which only height and weight were obtained. Enrollment was rolling. All procedures were approved by the Institutional Review Boards at the Miriam Hospital and California Polytechnic State University in accordance with the Declaration of Helsinki. The MTT study was also conducted in collaboration with Temple University whose Institutional Review Board determined it to be exempt due to no participant enrollment or data collection being done at this site and that data transferred and analyzed at Temple was considered by the IRB to be de-identified.

Measures

Depressive Symptoms: Mothers completed the Beck Depression Inventory II (BDI-II) to assess the presence and severity of depressive symptoms in the past 2 weeks at HB/CS baseline (9–15 weeks gestation), 35 weeks’ gestation, and after delivery at 6, 12, 18, and 24 months [40]. This 21-item measure is widely used and has been validated in diverse populations [41]. Higher total scores indicate higher severity of depressive symptoms. Scores from 0 to 9 suggest no or minimal depression; scores from 10 to 18 indicate mild to moderate depression; scores from 19 to 29 indicate moderate to severe depression; and scores from 30 to 63 indicate severe depression [42]. The measure had good internal reliability in this sample (Cronbach’s alpha = 0.9).

Responsiveness to child satiation cues was assessed in the video recorded meals at the 18 and 24-month assessments. Trained research assistants coded maternal responsiveness to satiation cues using the Responsiveness to Child Feeding Cue Scale (RCFCS) and rated mothers on a 5-point Likert scale (1 highly unresponsive- highly responsive) [43]. Mothers were rated as more versus less responsive based on the response latency to both the number and intensity of toddler-displayed satiation cues. Mothers who respond to earlier and more subtle satiation cues (e.g., slows or pauses pace of feeding) are rated as having higher responsiveness than those who respond to later and more overt child satiation cues (e.g., pushing plate away, playing with food).

20% of videos were coded by two or more trained coders who were fluent in the language spoken during the meal (English or Spanish) to determine interrater reliability. Three raters coded the videos recorded in English and two coded the videos recorded in Spanish. Intraclass correlation coefficients (ICCs) were used to determine reliability for maternal responsiveness ratings, which was adequate (ICC = 0.58 for videos in English and 0.60 for videos in Spanish).

Mothers also completed the Child Feeding Questionnaire (CFQ) at the 18 and 24-month assessments [44]. This 31-item survey assesses reported attitudes, beliefs, and practices relating to child feeding. Items were rated on a 5-point Likert scale with higher scores indicating greater endorsement of the behavior. For this analysis, we assessed the two subscales related to attitudes and practices regarding the use of coercive/controlling feeding strategies; pressure to eat and restriction. The pressure to eat subscale reflects a tendency to pressure their child to eat more food, “My child should always eat all the food on their plate”. The restriction subscale reflects the extent to which parents restrict access to foods, “I intentionally keep foods out of my child’s reach”. The CFQ also assesses caregivers’ concern for their child’s risk of overweight which was included as a covariate as it has demonstrated a consistent association with caregivers’ use of restriction. We calculated scores by taking the mean of each item in a subscale. The CFQ had acceptable-good internal reliability in this sample (Cronbach α = 0.7–0.9).

Child Characteristics: Mothers completed the Infant Behavior Questionnaire-Revised Very Short Form (IBQR VSF) which measures three dimensions of temperament: effortful control, surgency/extraversion, and negative affectivity [45]. This 37-item measure has established validity among diverse groups [43]. The effortful control subscale assesses the ability of a child to control attention and behavior, the surgency subscale measures the degree to which a child approaches novel stimuli, expresses positive emotions, is physically/vocally active, and is sensitive to stimuli in the environment. The negative affectivity subscale measures the degree to which a child expresses sadness, fear, and distress. Mothers rated how often their child engaged in behaviors for each subscale (e.g., Play with one toy for 5 to 10 min, move quickly toward new objects, show distress when tired) on a scale from 1 (Never) to 7 (Always) and a mean score was calculated for each subscale.

Trained research staff collected child anthropometric measurements using standardized methods [46]. Weight was obtained in light clothing without shoes. Recumbent length was measured at the 18-month assessment and standing height was measured at the 24-month assessment. Body Mass Index (BMI) z-scores were calculated based on the child’s age and sex using the World Health Organization growth standards [47].

Sociodemographic Characteristics: Mothers reported sociodemographic characteristics including their age, ethnicity, education level, household income, as well as child’s age and gender. Participants self-identified ethnicity as Hispanic/Latino or not Hispanic Latino and race as American Indian or Alaska Native, Asian, Black, Native Hawaiian or Pacific Islander, White, or Other. Mothers also completed the 2-item household food insecurity screener [48].

Analysis

We conducted group-based trajectory modeling (GBTM) using the R lcmm package (Proust-Lima, 2017) to model depressive symptom trajectory patterns in MTT participants with more than one postpartum BDI measurement (n = 151, 93% of full sample), using maximum likelihood estimation to account for missing data [49, 50]. We first normalized BDI scores to account for the left-skewed distribution commonly seen in the assessment of depressive symptoms. We then used a linear mixed model to identify the shape of the relationship between depressive symptoms over time. Based on previous literature we anticipated significant individual variability, with 2–4 distinct trajectories of depressive symptoms [51]. We then compared models predicting 1–5 clusters as a quadratic function of time, allowing growth to vary between classes. We assessed fit based on the following criteria: Minimize Bayesian Information Criterion (BIC), average posterior probability of assignment (APPA) ≥ 0.7 and nearer to 1, relative entropy nearer to 1, % smallest class ≥ 5, and visual evaluation of actual and predicted trajectories [52].

We then restricted the sample to MTT participants who had completed at least one feeding assessment (n = 111, 68% of the full sample). Of these participants, 29% were missing at least one key variable (feeding variable or covariate) at the 18-month assessment and 18% of participants were missing at least one key variable at the 24-month assessment. We assessed the correlation between missingness and study variables, sociodemographic characteristics, and study site (RI or CA) and found that missingness at the 18-month assessment was correlated with Black race (r = 0.2, p = 0.03), the RI site (r = 0.4, p < 0.0001), and effortful control (r = 0.2, p = 0.02) while missingness at the 24-month assessment was correlated with negative affectivity (r=-0.2, p = 0.02). Therefore, a complete case analysis would result in a sample with fewer Black mothers, and children with higher effortful control and lower negative affectivity. Variables were considered missing at random, at least partially explained by the limited initial funding and enrollment window of the study leading to some dyads not enrolling until after the 18-month visit. We imputed missing variables using a fully conditional specification algorithm with logistic regression for binary and ordinal variables (food insecurity, maternal responsiveness) and predictive mean matching for continuous variables (temperament, pressure to eat, restriction) including all study variables and maternal race as an auxiliary variable. We created 50 imputations, and the results of all subsequent analyses were pooled across imputations.

We compared sample characteristics across depressive symptom trajectory groups using generalized linear models for continuous variables and Chi-square and Fisher’s exact tests for categorical variables. We also explored changes in the time-varying variables (feeding, food insecurity, child weight, and temperament) using linear mixed models.

To assess the association between the depressive symptom trajectory group and feeding, we used generalized regressions assuming a normal distribution for continuous variables (pressure and restriction) and a multinomial distribution with a cumulative logit link for ordinal variables (maternal responsiveness). We identified covariates associated with food parenting in the literature a-priori including maternal age, ethnicity, education level, household income, and food insecurity, and concern for child weight status as well as the child’s age, gender, and BMI z-score [53,54,55,56]. We also adjusted for the intervention group (multicomponent weight management or usual care) and site (CA or RI). Child temperament variables were tested individually as candidate covariates in each model; however, inclusion did not change the main effect by greater than 10% and therefore temperament was not adjusted for in the final model.

Post-hoc exploratory analysis

We also conducted an exploratory analysis to explore potential bidirectional associations between mothers and their children. We calculated Pearson correlation coefficients and used Fisher z-transformation to calculate the standard error so that estimates could be pooled across imputations. Because we were interested in the association between depressive symptoms and mothers’ responsiveness to their children, we then examined interaction effects between depressive symptoms and child temperament on the association with feeding variables. Due to the modest sample size and unequal groups identified using GBTM, we conducted this analysis using continuous mean BDI-II scores to maximize our power to detect moderation effects. We conducted a criterion power analysis using G-Plus and determined that our sample size was sufficient to detect a moderation effect (increase in variance explained by the model including the interaction term) with an alpha set at 0.1. We then conducted a simple slopes analysis to examine associations with an observed interaction effect.

Results

Depressive Symptom Trajectory groups

Linear mixed models revealed a significant fixed effect (\(B\) =-0.12, p-value = 0.002) and random effect (\(B\) =0.04, p-value = 0.049) of time on depressive symptoms. Of the 1–5 group models tested, the 3-group model best fit the data based on model fit (lowest BIC, satisfactory average posterior probability assignment, entropy, smallest group %, Table 1) and clinical significance (distinct mean depressive symptoms and % experiencing > minimal depressive symptoms (BDI-II score > 9) at each timepoint, Table 2). The first trajectory was characterized by no-minimal depressive symptoms at baseline that decreased significantly over time, the second trajectory was characterized by mild-moderate depressive symptoms at baseline that were stable over time, and the third trajectory was characterized by moderate-severe depressive symptoms at baseline that increased over time, however, the increase was not significant. The predicted probability of group membership was 48% No-Minimal and Decreasing, 39% Mild-Moderate and Stable, and 13% Moderate-Severe and Stable (Fig. 1).

Table 1 Model fit statistics comparing 1–5 class group-based trajectory models
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Fig. 1
figure 1

Group membership modeled using group-based trajectory modeling. 3 Group 1 represented in blue (n = 76, 48%), Group 2 represented in red (n = 56, 39%) Group 3 represented in green (n = 19,13%)

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Table 2 BDI-II1 scores over study period by depressive symptom trajectory groups
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Sample characteristics

Table 3 presents the characteristics of the sample, which consisted of 111 ethnically and socioeconomically diverse mother/child dyads. Compared with the No-Minimal and Decreasing group, the Moderate-Severe and Stable group was younger (p-value = 0.02), less likely to be married (p = 0.04), and more likely to be experiencing food insecurity at 18-months (p-value = 0.01) and 24-months (p-value = 0.02). Compared to children of women in the No-Minimal and Decreasing group, children of women in the Moderate-Severe and Stable group had higher surgency at the 24-month assessment (p-value = 0.02). There were no other significant differences observed between groups.

Changes in study variables over time

Self-reported and observed feeding variables at the 18 and 24-month timepoints are presented in Table 4. On average, child effortful control increased from the 18-month to 24-month assessment (\(B\)=0.3, p-value = 0.0006), with no time-by-trajectory group interaction. On average, child surgency was stable across time points (\(B\)= 0.0, p-value = 0.6), however, there was a significant time-by-trajectory group interaction, with the Moderate-Severe and Stable group associated with an increase in reported surgency from the 18-month to 24-month assessment (\(B\) =0.6 p-value = 0.03). Feeding variables and child BMI-z scores were stable across time, with no evidence of a time-by-group interaction.

Table 3 Characteristics of participants in the mealtime for toddlers study by depressive symptom trajectory group
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Table 4 Self-reported and observed child feeding by depressive symptom trajectory group at 18 and 24-months postpartum
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At the 18-month assessment, when compared to the No-Minimal and Decreasing group, membership in the Moderate-Severe and Stable group was associated with higher maternal responsiveness to child satiation cues (\(B\) =2.3, 95%CI = 0.2, 4.4) and lower self-reported pressure to eat (\(B\)=-0.4, 95%CI= -0.7, 0.0). When compared to the No-Minimal and Decreasing group, membership in the Mild-Moderate and Stable group was associated with higher self-reported restriction (\(B\) =0.4, 95%CI = 0.0,0.7). Depressive trajectory group membership was not associated with self-reported or observed feeding practices at the 24-month assessment.

Table 5 Associations between maternal depressive symptom trajectory group and maternal feeding practices
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Associations between continuous mean BDI-II score and child temperament with feeding

Correlations between continuous variables are shown in Supplemental Table 1. Mean BDI-II scores were positively correlated with concern for child weight status and child surgency at 24 months (r = 0.34, p-value = 0.001 and r = 0.23, p-value = 0.02, respectively). Mean BDI-II scores were not significantly correlated with self-reported or observed feeding.

Effortful control at 18 months was negatively correlated with maternal responsiveness to satiation cues at 24 months (r=-0.24, p-value = 0.048). Surgency was positively correlated with restriction at 24-months (r = 0.21, p-value = 0.04).

There was an interaction between mean BDI-II score and child effortful control on the association with restriction at 18 months, \(B=0.2, 95\% CI (0.0, 04)\); whereby greater maternal depressive symptoms predicted greater use of restriction when children had high effortful control (1 standard deviation greater than the mean), \(B=0.1, p-value=0.01\)(Supplemental Fig. 1).

There was an interaction between mean BDI-II score and child surgency in the association with restriction at 24 months \(B=-0.3, 95\% CI (-0.6, 0.0)\); with greater maternal depressive symptoms associated with greater use of restriction when children had low surgency (1 SD less than the mean), \(B=0.1, p=0.06\)(Supplemental Fig. 2).

Discussion

In this analysis, we found that mothers who participated in a prenatal lifestyle randomized controlled trial exhibited three distinct trajectories of depressive symptoms through the first two years postpartum. The three trajectories were characterized primarily by the severity of symptoms. While we found some evidence that a trajectory with elevated depressive symptoms were associated with greater restriction at 18 months, our results overall did not support the hypothesis that elevated depressive symptoms are associated with less responsive feeding as assessed via observation and self-report. We did however find that the association between maternal depressive symptoms and use of restriction may be moderated by their child’s temperament.

Our finding that mothers who participated in the HB/CS study exhibited three distinct depressive symptom trajectories characterized by severity is consistent with the broader literature on postpartum depressive symptomatology [51, 57, 58]. While many have hypothesized that some women may be more likely to experience an increase in depressive symptomology in the postpartum period, our data and that of others suggest that women who experience higher levels of depressive symptoms postpartum have likely had pre-existing elevated depressive symptoms [57,58,59,60,61]. A systematic review of longitudinal studies on depressive symptoms found that the majority of individuals experience minimal depressive symptoms, with a minority of ~ 10% experiencing elevated symptoms, associated with female gender, low income and education, and non-white race [60]. While most women in this study experienced minimal depressive symptoms during pregnancy which significantly decreased over the postpartum period, women who had mild and moderate symptoms saw them persist. This highlights the need for depressive screening prenatally to identify mothers with elevated depressive symptoms, rather than waiting until the post-partum period. It may also be warranted to monitor women with mild depressive symptoms which, if persistent, may impact the mother/child feeding relationship.

Membership in the Moderate-Severe and Stable trajectory group was not associated with lower responsiveness to satiation cues, greater pressure to eat, or greater restriction. Surprisingly, we found that mothers in the Moderate-Severe and Stable group were more responsive to their child’s satiation cues at the 18-month assessment, as assessed by video observation and self-report. However, it is important to acknowledge that this study was conducted in a sample of women who participated in a prenatal lifestyle intervention, and few (n = 12) experienced Moderate-Severe and Stable trajectories. Thus, these results are not representative of women with elevated depressive symptoms broadly and, given the small number in this trajectory group, needs to be interpreted with some caution. A meta-analysis exploring the association between depressive symptoms and maternal sensitivity to infant cues found a small but meaningful association (r=-0.16, p < 0.0001), and demonstrated that the effect was larger when studies examined differences between mothers with and without clinical depression (-0.35, p < 0.0001) [62]. Additionally, satiation cues generally become easier to recognize from infancy throughout toddlerhood, although satiation cues remain more challenging to identify as compared to hunger cues [28]. Impaired ability to recognize and respond to child satiation cues may be more pronounced in women with clinical depression or severe depressive symptoms (BDI-II score > 30), who were not represented in this sample [40].

Previous studies have found depressive symptoms to be associated with less responsiveness to child satiation cues, although the majority report assessing feeding at or over 24 months of age [14, 27, 31]. For example, Mallan et al. found that depressive symptoms in the postpartum period (4 months) were associated with greater self-reported pressure to eat at 24 months [31], and Elias et al. found a cross-sectional association between depressive symptoms and observed pressure to eat [63]; both adjusting for caregiver perception of difficult child temperament. While maternal pressure to eat is generally reported to be stable over time [64], as seen in our data, mothers in the moderate-severe and stable? depressive symptom group had higher observed responsiveness to satiation cues and lower self-reported pressure to eat at the 18-month, but not 24-month assessment suggesting that there may be a change in the association between depressive symptoms on feeding that develops as children grow. Blisset et al. also found different associations across time points, with results demonstrating that depressive symptoms at 12 months predicted higher use of pressure at 24 months, but not at 12 months [53]. Taken together these results provide evidence that women who have stable trajectories of mild or moderate depressive symptoms can be responsive to their child’s satiation cues, however, the impact of their depressive symptoms on their feeding practices may change as children grow.

One potential explanation for this potential change is that as children approach 24 months of age, their growth rate begins to slow, resulting in decreased or more erratic appetite compared to infancy. Concurrently, children are developing effortful control (goal-oriented, volitional behavior), which typically emerges towards the end of the first years of life [65, 66]. This was seen in our data as children’s effortful control, on average, increased from 18 to 24 months. The combination of decreased appetite and developing autonomy often results in children exerting more control regarding food choices and intake [67]. While these changes are developmentally appropriate, many mothers experience low parental self-efficacy and feelings of concern, frustration, and guilt when children refuse food at meals [68]. These feelings may be particularly salient for women who have already been experiencing chronic depressive symptoms, causing mothers to turn to less supportive feeding strategies [9].

Consistent with previous research on maternal depression and feeding practices, we did find evidence that, when compared to those in the No-Minimal and Decreasing group, those in the Mild-Moderate and Stable group reported greater use of restriction at 18 months [53]. However, this association was not significant for the Moderate-Severe and Stable group at 18 months nor for either group at the 24-month assessment. This finding may suggest that chronic, mild-moderate, depressive symptoms influence mothers’ use of restriction early in toddlerhood, which could increase the emotional valiance and intake of foods that are restricted and lead to poorer long-term self-regulation for some children [54].

It is important to note however that the utility of restrictive feeding practices can depend on contextual factors such as the way that they are implemented and the individual temperament of the child. Overt restriction without regard for the feelings of the child, such as withholding palatable foods others are consuming, can promote future intake of that food [69]. However, more covert strategies assessed in the CFQ such as modifying the visibility and accessibility of foods (“I intentionally keep some foods out of my child’s reach”) and awareness of the impact of foods that are high in sugar and added fats (“I have to be sure that my child does not eat too many sweets (candy, ice cream, cake, pastries)”) can be achieved by controlling the feeding environment without controlling the child’s behavior. In fact, these strategies may be protective for children who have less inhibitory control and/or are more responsive to their environment [70]. There is an emerging body of research that suggests that the feeding relationship between caregiver and child is bi-directional, with children shaping their parents’ use of feeding practices [71,72,73]. Indeed, an important characteristic of responsive parenting is that the caregiver’s responses should be contingent on their child’s cues and behavior [74,75,76]. For example, caregivers of children who are very responsive to their environment may respond to constant requests for sweets by using restriction around the foods they bring into the home to prevent excess weight gain [76, 77]. We did see evidence of this in our data, with mother’s concern for their child’s weight positively correlated with restriction at both time points. We also saw that child surgency was positively correlated with restriction at 24-months, perhaps in response to their child’s behavior, as surgency is associated with increased eating in response to external cues, higher desire to eat, and more pleasure derived from food [78, 79].

Interestingly, in our exploratory analysis, continuous mean depressive symptom scores were positively associated with restriction when children had high levels of effortful control (18 months) and low levels of surgency or responsiveness to their environment (24 months). This could reflect a mismatch between feeding strategies and the needs of the child; when depressive symptoms are higher, mothers reported greater restriction if their children had temperaments not associated with increased obesogenic eating behaviors [80]. The impact of this mismatch may be compounded by the fact that mothers in the Moderate group reported an increase in child surgency from 18 to 24 months. This is a trend seen in other studies of mothers with depression such that children with higher surgency may benefit from more maternal control of the feeding environment. This analysis looked at mean continuous BDI scores, as we were not powered to evaluate the complex bi-directional, direct, and indirect relationships between maternal depressive symptom trajectory, child temperament, and responsive feeding. However, these exploratory results suggest that depressive symptoms may impact mothers’ ability to adjust their feeding strategies to the temperament of their child.

The limitations of the study are important to note. First, MTT is a sample of women who participated in the HB/CS randomized trial, therefore all women had obesity and consented to be randomized to a multi-component lifestyle intervention or usual prenatal care during pregnancy. While understanding the role of depressive symptoms and child feeding is important in this high-risk population, these results cannot be generalized to mothers without obesity or mothers with obesity who were not interested in participating in a prenatal lifestyle intervention. Mothers who were interested in making lifestyle changes to promote weight loss may have lived experiences and beliefs about weight, eating, and health that could influence how depressive symptoms relate to their food parenting behaviors. While we were able to objectively assess maternal responsiveness to satiation cues using video observation, ICC was acceptable but indicative of some disagreement between coders [81]. Additionally, the sample size was relatively small, and depressive symptoms in the sample were minimal on average. While we were able to examine the impact of child temperament on the relationship between depressive symptoms and feeding, these analyses were exploratory and meant to be hypothesis-generating. As we were not testing a-priori hypotheses we acknowledge that significant associations may be false positives and that more research, with larger samples that target women with clinical depression, may be needed to uncover the true nature of the relationship between maternal depressive symptoms, child temperament, and feeding. In light of these limitations, this study has several strengths including rich, longitudinal data on a diverse sample of women whose children are at increased risk for developing obesity. The collection of both self-reported and observed maternal feeding, and consistency between the associations with depressive symptom trajectory strengthens our ability to interpret these findings.

This study provides valuable insight into the association between maternal depression and child feeding and temperament. We found that, contrary to our hypothesis, a moderate-severe and stable? maternal depressive symptom trajectory was not associated with less responsive feeding practices. We did find evidence that the Mild-Moderate and Stable group was associated with greater self-reported restrictive feeding practices at 18 months and preliminary evidence that maternal depressive symptoms may impair mothers’ ability to match their feeding strategies to their child’s unique temperament. It is reassuring that stable mild-moderate and moderate-severe depressive symptoms did not impair women in this study’s ability to recognize and respond to their young child’s satiation cues. However, future efforts to understand and promote mutually responsive feeding between mothers with obesity and their children should consider the impact of depressive symptoms on mother’s use of restriction, and how it relates to the unique temperament of their child.

Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

Abbreviations

HB/CS:

Healthy Beginnings/ Comienzos Saludables

MTT:

Mealtime for Toddlers

BDI-II:

Beck Depression Inventory II

RCFCS:

Responsiveness to Child Feeding Cue Scale

ICCs:

Intraclass correlation coefficients

CFQ:

Child Feeding Questionnaire

IBQR VSF:

Infant Behavior Questionnaire-Revised Very Short Form

GBTM:

Group-based trajectory modeling

BIC:

Bayesian Information Criterion

APPA:

Average Posterior Probability of Assignment

References

  1. Anzman-Frasca S, Ventura AK, Ehrenberg S, Myers KP. Promoting healthy food preferences from the start: a narrative review of food preference learning from the prenatal period through early childhood. Obes Reviews: Official J Int Association Study Obes. 2018;19(4):576–604.

    Article  CAS  Google Scholar 

  2. Herle M, Fildes A, Steinsbekk S, Rijsdijk F, Llewellyn CH. Emotional over- and under-eating in early childhood are learned not inherited. Sci Rep. 2017;7(1):9092.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Herle M, Stavola B, Hubel C, Ferreira DLS, Abdulkadir M, Yilmaz Z, Loos RJF, Bryant-Waugh R, Bulik CM, Micali N. Eating behavior trajectories in the first 10 years of life and their relationship with BMI. Int J Obes (Lond). 2020;44(8):1766–75.

    Article  PubMed  Google Scholar 

  4. Anderson SE, Keim SA. Parent-child Interaction, Self-Regulation, and Obesity Prevention in Early Childhood. Curr Obes Rep. 2016;5(2):192–200.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bergmeier H, Skouteris H, Horwood S, Hooley M, Richardson B. Associations between child temperament, maternal feeding practices and child body mass index during the preschool years: a systematic review of the literature. Obes Rev. 2014;15(1):9–18.

    Article  CAS  PubMed  Google Scholar 

  6. Bergmeier H, Skouteris H, Horwood S, Hooley M, Richardson B. Child temperament and maternal predictors of preschool children’s eating and body mass index. A prospective study. Appetite. 2014;74:125–32.

    Article  PubMed  Google Scholar 

  7. Holley CE, Haycraft E, Farrow C. Unpacking the relationships between positive feeding practices and children’s eating behaviours: the moderating role of child temperament. Appetite. 2020;147:104548.

    Article  PubMed  Google Scholar 

  8. Hughes SO, Power TG, Papaioannou MA, Cross MB, Nicklas TA, Hall SK, Shewchuk RM. Emotional climate, feeding practices, and feeding styles: an observational analysis of the dinner meal in Head Start families. In.; 2011.

  9. Hughes SO, Shewchuk RM. Child temperament, parent emotions, and perceptions of the child’s feeding experience. In.; 2012.

  10. Johnson CM, Henderson MS, Tripicchio G, Rozin P, Heo M, Pietrobelli A, Berkowitz RI, Keller KL, Faith MS. Observed parent-child feeding dynamics in relation to child body mass index and adiposity. Pediatr Obes. 2018;13(4):222–31.

    Article  CAS  PubMed  Google Scholar 

  11. Niermann CYN, Gerards S, Kremers SPJ. Conceptualizing Family Influences on Children’s Energy Balance-Related Behaviors: Levels of Interacting Family Environmental Subsystems (The LIFES Framework). Int J Environ Res Public Health 2018, 15(12).

  12. Hughes SO, Power TG, Orlet Fisher J, Mueller S, Nicklas TA. Revisiting a neglected construct: parenting styles in a child-feeding context. Appetite. 2005;44(1):83–92.

    Article  PubMed  Google Scholar 

  13. Balantekin KN, Anzman-Frasca S, Francis LA, Ventura AK, Fisher JO, Johnson SL. Positive parenting approaches and their association with child eating and weight: a narrative review from infancy to adolescence. Pediatr Obes 2020.

  14. Bergmeier H, Paxton SJ, Milgrom J, Anderson SE, Baur L, Hill B, Lim S, Green R, Skouteris H. Early mother-child dyadic pathways to childhood obesity risk: a conceptual model. Appetite. 2020;144:104459.

    Article  PubMed  Google Scholar 

  15. Grammer AC, Balantekin KN, Barch DM, Markson L, Wilfley DE. Parent-child influences on child eating self-regulation and weight in early childhood: a systematic review. Appetite. 2022;168:105733.

    Article  PubMed  Google Scholar 

  16. Wehrly SE, Bonilla C, Perez M, Liew J. Controlling parental feeding practices and child body composition in ethnically and economically diverse preschool children. Appetite. 2014;73:163–71.

    Article  PubMed  Google Scholar 

  17. Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, et al. Caregiver influences on eating behaviors in Young Children: A Scientific Statement from the American Heart Association. J Am Heart Assoc. 2020;9(10):e014520.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Boswell N, Byrne R, Davies PSW. An examination of children’s eating behaviours as mediators of the relationship between parents’ feeding practices and early childhood body mass index z -scores. Obes Sci Pract. 2019;5(2):168–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Webber L, Cooke L, Hill C, Wardle J. Associations between children’s appetitive traits and maternal feeding practices. J Am Diet Assoc. 2010;110(11):1718–22.

    Article  PubMed  Google Scholar 

  20. Durao C, Andreozzi V, Oliveira A, Moreira P, Guerra A, Barros H, Lopes C. Maternal child-feeding practices and dietary inadequacy of 4-year-old children. Appetite. 2015;92:15–23.

    Article  PubMed  Google Scholar 

  21. Gubbels JS, Kremers SPJ, Stafleu A, de Vries SI, Goldbohm RA, Dagnelie PC, de Vries NK, van Buuren S, Thijs C. Association between parenting practices and children’s dietary intake, activity behavior and development of body mass index: The KOALA Birth Cohort Study. In.; 2011.

  22. Arlinghaus KR, Vollrath K, Hernandez DC, Momin SR, O’Connor TM, Power TG, Hughes SO. Authoritative parent feeding style is associated with better child dietary quality at dinner among low-income minority families. Am J Clin Nutr. 2018;108(4):730–6.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Tovar A, Choumenkovitch SF, Hennessy E, Boulos R, Must A, Hughes SO, Gute DM, Kuross Vikre E, Economos CD, Friedman DR. Low demanding parental feeding styles is Associated with low consumption of whole grains among children of recent immigrants HHS Public Access. Appetite. 2015;95:211–8.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tovar A, Hennessy E, Pirie A, Must A, Gute DM, Hyatt RR, Kamins CL, Hughes SO, Boulos R, Sliwa S et al. Feeding styles and child weight status among recent immigrant mother-child dyads. In.; 2012.

  25. Hennessy E, Hughes SO, Goldberg JP, Hyatt RR, Economos CD. Permissive parental feeding behavior is associated with an increase in intake of low-nutrient-dense foods among American children living in rural communities. J Acad Nutr Diet. 2012;112(1):142–8.

    Article  PubMed  Google Scholar 

  26. El-Behadli AF, Sharp C, Hughes SO, Obasi EM, Nicklas TA. Maternal depression, stress and feeding styles: towards a framework for theory and research in child obesity. Br J Nutr. 2015;113(Suppl):S55–71.

    Article  CAS  PubMed  Google Scholar 

  27. Lindsay AC, Mesa T, Greaney ML, Wallington SF, Wright JA. Associations between maternal depressive symptoms and nonresponsive feeding styles and practices in mothers of Young children: a systematic review. JMIR Public Health Surveill. 2017;3(2):e29.

    Article  PubMed  PubMed Central  Google Scholar 

  28. McNally J, Hugh-Jones S, Caton S, Vereijken C, Weenen H, Hetherington M. Communicating hunger and satiation in the first 2 years of life: a systematic review. Matern Child Nutr. 2016;12(2):205–28.

    Article  PubMed  Google Scholar 

  29. Norcross PL, Bailes LG, Leerkes E. Effects of maternal depressive symptoms on sensitivity to infant distress and non-distress: role of SES and race. Infant Behav Dev. 2020;61:101498.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Goulding AN, Rosenblum KL, Miller AL, Peterson KE, Chen Y-P, Kaciroti N, Lumeng JC. Associations between maternal depressive symptoms and child feeding practices in a cross-sectional study of low-income mothers and their young children. Int J Behav Nutr Phys Activity. 2014;11(1):75.

    Article  Google Scholar 

  31. Mallan KM, Daniels LA, Wilson JL, Jansen E, Nicholson JM. Association between maternal depressive symptoms in the early post-natal period and responsiveness in feeding at child age 2 years. Matern Child Nutr. 2015;11(4):926–35.

    Article  PubMed  Google Scholar 

  32. McMeekin S, Jansen E, Mallan K, Nicholson J, Magarey A, Daniels L. Associations between infant temperament and early feeding practices. A cross-sectional study of Australian mother-infant dyads from the NOURISH randomised controlled trial. Appetite. 2013;60(1):239–45.

    Article  PubMed  Google Scholar 

  33. Lampard AM, Franckle RL, Davison KK. Maternal depression and childhood obesity: a systematic review. Prev Med. 2014;59:60–7.

    Article  PubMed  Google Scholar 

  34. Arlinghaus KR, Power TG, Hernandez DC, Johnston CA, Hughes SO. The association between maternal depressive symptomology and child dinner dietary quality among hispanic Head Start families. Prev Med Rep. 2020;20:101196.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Marshall SA, Ip EH, Suerken CK, Arcury TA, Saldana S, Daniel SS, Quandt SA. Relationship between maternal depression symptoms and child weight outcomes in latino farmworker families. Matern Child Nutr. 2018;14(4):e12614.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Johar H, Hoffmann J, Gunther J, Atasoy S, Stecher L, Spies M, Hauner H, Ladwig KH. Evaluation of antenatal risk factors for postpartum depression: a secondary cohort analysis of the cluster-randomised GeliS trial. BMC Med. 2020;18(1):227.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk factors for childhood obesity in the First 1,000 days: a systematic review. Am J Prev Med. 2016;50(6):761–79.

    Article  PubMed  Google Scholar 

  38. Phelan S, Hart CN, Jelalian E, Munoz-Christian K, Alarcon N, McHugh A, Ventura AK, Wing RR. Effect of prenatal lifestyle intervention on maternal postpartum weight retention and child body mass index z-score at 36 months. Int J Obes (Lond). 2021;45(5):1133–42.

    Article  PubMed  Google Scholar 

  39. Hart CN, Phelan S, Coffman DL, Jelalian E, Ventura AK, Hodges EA, Hawley N, Fisher JO, Wing RR. Maternal responsiveness and toddler body mass index z-score: prospective analysis of maternal and child mealtime interactions. Appetite. 2023;180:106348.

    Article  CAS  PubMed  Google Scholar 

  40. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77–100.

    Article  Google Scholar 

  41. Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Braz J Psychiatry. 2013;35(4):416–31.

    Article  PubMed  Google Scholar 

  42. Kendall PC, Hollon SD, Beck AT, Hammen CL, Ingram RE. Issues and recommendations regarding use of the Beck Depression Inventory. Cogn Therapy Res. 1987;11(3):289–99.

    Article  Google Scholar 

  43. Hodges EA, Johnson SL, Hughes SO, Hopkinson JM, Butte NF, Fisher JO. Development of the responsiveness to child feeding cues scale. Appetite. 2013;65:210–9.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Birch LL, Fisher JO, Grimm-Thomas K, Markey CN, Sawyer R, Johnson SL. Confirmatory factor analysis of the child feeding questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite. 2001;36(3):201–10.

    Article  CAS  PubMed  Google Scholar 

  45. Putnam SP, Helbig AL, Gartstein MA, Rothbart MK, Leerkes E. Development and assessment of short and very short forms of the infant behavior questionnaire-revised. J Pers Assess. 2014;96(4):445–58.

    Article  PubMed  Google Scholar 

  46. Group WHOMGRS. Reliability of anthropometric measurements in the WHO Multicentre Growth Reference Study. Acta Paediatr Suppl. 2006;450:38–46.

    Google Scholar 

  47. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85(9):660–7.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Hager ER, Quigg AM, Black MM, Coleman SM, Heeren T, Rose-Jacobs R, Cook JT, Ettinger de Cuba SA, Casey PH, Chilton M, et al. Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics. 2010;126(1):e26–32.

    Article  PubMed  Google Scholar 

  49. Proust-Lima C, Sebille V. Recent developments for the analysis of latent constructs using measurement scales in health research. Methods. 2022;205:232–3.

    Article  CAS  PubMed  Google Scholar 

  50. Nagin DS. Group-based trajectory modeling: an overview. Ann Nutr Metab. 2014;65(2–3):205–10.

    Article  CAS  PubMed  Google Scholar 

  51. Lee C-T, Stroo M, Fuemmeler B, Malhotra R, Østbye T. Trajectories of depressive symptoms over 2 years Postpartum among overweight or obese women. Women’s Health Issues. 2014;24(5):559–66.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Nagin DS, Odgers CL. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010;6:109–38.

    Article  PubMed  Google Scholar 

  53. Blissett J, Farrow C. Predictors of maternal control of feeding at 1 and 2 years of age. Int J Obes (Lond). 2007;31(10):1520–6.

    Article  CAS  PubMed  Google Scholar 

  54. Haszard JJ, Skidmore PML, Williams SM, Taylor RW. Associations between parental feeding practices, problem food behaviours and dietary intake in New Zealand overweight children aged 4–8 years. Public Health Nutr 2015, 18(6).

  55. Lindholm A, Bergman S, Alm B, Bremander A, Dahlgren J, Roswall J, Staland-Nyman C, Almquist-Tangen G. Nutrition- and feeding practice-related risk factors for rapid weight gain during the first year of life: a population-based birth cohort study. BMC Pediatr. 2020;20(1):507.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Saltzman JA, Bost KK, Musaad SMA, Fiese BH, Wiley AR, Harrison K, McBride B, Donovan S, Grigsby-Toussaint D, Kim J, et al. Predictors and outcomes of Mealtime emotional climate in families with preschoolers. J Pediatr Psychol. 2018;43(2):195–206.

    Article  PubMed  Google Scholar 

  57. Miller ES, Saade GR, Simhan HN, Monk C, Haas DM, Silver RM, Mercer BM, Parry S, Wing DA, Reddy UM, Grobman WA. Trajectories of antenatal depression and adverse pregnancy outcomes. Am J Obstet Gynecol. 2022;226(1):108. e101-108 e109.

    Article  Google Scholar 

  58. Ramos-Marcuse F, Oberlander SE, Papas MA, McNary SW, Hurley KM, Black MM. Stability of maternal depressive symptoms among urban, low-income, African American adolescent mothers. J Affect Disord. 2010;122(1–2):68–75.

    Article  PubMed  Google Scholar 

  59. Lee CT, Stroo M, Fuemmeler B, Malhotra R, Ostbye T. Trajectories of depressive symptoms over 2 years postpartum among overweight or obese women. Womens Health Issues. 2014;24(5):559–66.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Musliner KL, Munk-Olsen T, Eaton WW, Zandi PP. Heterogeneity in long-term trajectories of depressive symptoms: patterns, predictors and outcomes. J Affect Disord. 2016;192:199–211.

    Article  PubMed  Google Scholar 

  61. Vanwetswinkel F, Bruffaerts R, Arif U, Hompes T. The longitudinal course of depressive symptoms during the perinatal period: a systematic review. J Affect Disord. 2022;315:213–23.

    Article  PubMed  Google Scholar 

  62. Bernard K, Nissim G, Vaccaro S, Harris JL, Lindhiem O. Association between maternal depression and maternal sensitivity from birth to 12 months: a meta-analysis. Attach Hum Dev. 2018;20(6):578–99.

    Article  PubMed  Google Scholar 

  63. Elias CV, Power TG, Beck AE, Goodell LS, Johnson SL, Papaioannou MA, Hughes SO. Depressive symptoms and perceptions of child Difficulty are Associated with Less Responsive feeding behaviors in an observational study of low-income mothers. Child Obes. 2016;12(6):418–25.

    Article  PubMed  Google Scholar 

  64. Silva Garcia K, Power TG, Beck AD, Fisher JO, Goodell LS, Johnson SL, O’Connor TM, Hughes SO. Stability in the feeding practices and styles of low-income mothers: questionnaire and observational analyses. Int J Behav Nutr Phys Act. 2018;15(1):28.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Kochanska G, Knaack A. Effortful control as a personality characteristic of young children: antecedents, correlates, and consequences. J Pers. 2003;71(6):1087–112.

    Article  PubMed  Google Scholar 

  66. Putnam SP, Gartstein MA, Rothbart MK. Measurement of fine-grained aspects of toddler temperament: the early childhood behavior questionnaire. Infant Behav Dev. 2006;29(3):386–401.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Walton K, Kuczynski L, Haycraft E, Breen A, Haines J. Time to re-think picky eating? A relational approach to understanding picky eating. Int J Behav Nutr Phys Act. 2017;14(1):62.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Wolstenholme H, Kelly C, Hennessy M, Heary C. Childhood fussy/picky eating behaviours: a systematic review and synthesis of qualitative studies. Int J Behav Nutr Phys Act. 2020;17(1):2.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Rollins BY, Loken E, Savage JS, Birch LL. Effects of restriction on children’s intake differ by child temperament, food reinforcement, and parent’s chronic use of restriction. Appetite. 2014;73:31–9.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Campbell K, Andrianopoulos N, Hesketh K, Ball K, Crawford D, Brennan L, Corsini N, Timperio A. Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study. Appetite. 2010;55(1):84–8.

    Article  PubMed  Google Scholar 

  71. Eagleton SG, Shriver LH, Buehler C, Wideman L, Leerkes EM. Bidirectional associations between maternal controlling feeding and food responsiveness during infancy. Front Public Health. 2022;10:975067.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Papaioannou MA, Micheli N, Power TG, O’Connor TM, Fisher JO, Hughes SO. Maternal feeding styles and Child Appetitive traits: Direction of effects in hispanic families with low incomes. Front Public Health. 2022;10:871923.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Jordan AA, Appugliese DP, Miller AL, Lumeng JC, Rosenblum KL, Pesch MH. Maternal prompting types and child vegetable intake: exploring the moderating role of picky eating. Appetite. 2020;146:104518.

    Article  PubMed  Google Scholar 

  74. Derks IPM, Sijbrands EJG, Wake M, Qureshi F, Van Der Ende J, Hillegers MHJ, Jaddoe VWV, Tiemeier H, Jansen PW. Eating behavior and body composition across childhood: a prospective cohort study 11 Medical and Health Sciences 1117 Public Health and Health Services. Int J Behav Nutr Phys Activity 2018, 15(1).

  75. Derks IPM, Tiemeier H, Sijbrands EJG, Nicholson JM, Voortman T, Verhulst FC, Jaddoe VWV, Jansen PW. Testing the direction of effects between child body composition and restrictive feeding practices: results from a population-based cohort. Am J Clin Nutr. 2017;106(3):783–90.

    Article  CAS  PubMed  Google Scholar 

  76. Jansen E, Williams KE, Mallan KM, Nicholson JM, Daniels LA. Bidirectional associations between mothers’ feeding practices and child eating behaviours. Int J Behav Nutr Phys Act. 2018;15(1):3.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Derks IP, Tiemeier H, Sijbrands EJ, Nicholson JM, Voortman T, Verhulst FC, Jaddoe VW, Jansen PW. Testing the direction of effects between child body composition and restrictive feeding practices: results from a population-based cohort. Am J Clin Nutr. 2017;106(3):783–90.

    Article  CAS  PubMed  Google Scholar 

  78. Leung CY, Miller AL, Kaciroti NA, Chen YP, Rosenblum K, Lumeng JC. Low-income pre-schoolers with higher temperamental surgency enjoy and respond more to food, mediating the path to higher body mass index. Pediatr Obes. 2016;11(3):181–6.

    Article  CAS  PubMed  Google Scholar 

  79. Leung CYY, Lumeng JC, Kaciroti NA, Chen YP, Rosenblum K, Miller AL. Surgency and negative affectivity, but not Effortful Control, are uniquely Associated with Obesogenic Eating behaviors among low-income preschoolers. Appetite. 2014;78:139–46.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Leung CY, Lumeng JC, Kaciroti NA, Chen YP, Rosenblum K, Miller AL. Surgency and negative affectivity, but not effortful control, are uniquely associated with obesogenic eating behaviors among low-income preschoolers. Appetite. 2014;78:139–46.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors acknowledge Angelica McHugh, Noemi Alarcon, and and Ashley Ogoe for their support with data management.

Funding

This research was supported by the National Institutes of Health National Heart, Lung, and Blood Institute (HL114377) and the National Institute of Diabetes and Digestive and Kidney Diseases (R56DK108661 and R01DK108661). LIFE-Moms is supported by the National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, U01 DK094418, U01 DK094463, U01 DK094416, 5U01 DK094466 [RCU]), the National Heart, Lung, and Blood Institute (NHLBI, U01 HL114344, U01 HL114377), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, U01 HD072834), the National Center for Complementary and Integrative Health (NCCIH), the NIH Office of Research in Women’s Health (ORWH), the Office of Behavioral and Social Science Research (OBSSR), the Indian Health Service, and the Intramural Research Program of the NIDDK.

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Authors and Affiliations

  1. Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA

    Katelyn Fox, Rena Wing & Elissa Jelalian

  2. Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA

    Katelyn Fox, Rena Wing & Elissa Jelalian

  3. Department of Social and Behavioral Sciences & Center for Obesity Research and Education, College of Public Health Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA, 19140, USA

    Chantelle N. Hart

  4. Department of Kinesiology and Public Health & Center for Health Research Bailey College of Science and Mathematics, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA

    Suzanne Phelan & Alison K. Ventura

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Contributions

KF was responsible for the conceptualization, analysis, and writing the initial draft. CNH, SP, AKV, RW, and EJ were responsible for the original data acquisition and contributed substantively to the interpretation of data, critical revision, and review of the manuscript.

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Correspondence to Katelyn Fox.

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Ethics approval and consent to participate

All participants provided written informed consent to participate to HB/CS and MTT. All procedures were approved by the Institutional Review Boards at the Miriam Hospital and California Polytechnic State University in accordance with the Declaration of Helsinki. The HB/CS trial was registered at www.clinicaltrials.gov as NCT01545934 with study completion June, 2020.

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Competing interests

The authors do not have competing interests relevant to this paper. Dr. Hart currently serves as a Consultant on a grant funded by the Novo Nordisk Foundation that is unrelated to this work. Dr. Phelan has a grant from WW International that is unrelated to this work. Drs. Ventura, Jelalian, Wing, and Fox do not have any financial interests to disclose.

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Fox, K., Hart, C.N., Phelan, S. et al. Maternal depressive symptom trajectories and associations with child feeding. BMC Public Health 24, 1636 (2024). https://doi.org/10.1186/s12889-024-19110-8

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