Rachel E Blaine1, Kirsten K Davison1, Kathryn Hesketh2, Elsie M Taveras3, Matthew W Gillman4, Sara E Benjamin Neelon5. 1. 1Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA. 2. 2University College London Institute of Child Health, London, United Kingdom. 3. 3Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA. 4. 4Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. 5. 5Department of Community and Family Medicine, Duke University Medical Center and Duke Global Health Institute, Durham, NC.
Abstract
BACKGROUND: Identifying characteristics associated with the Institute of Medicine's (IOM) recommended feeding practices among infant and toddler care providers in child care centers could help in preventing childhood obesity. METHODS: In 2009, at baseline in a pilot intervention study of 29 licensed Massachusetts child care centers with at least 50% of enrolled children identified as racial minorities, 57 infant and 109 toddler providers completed feeding questionnaires. To assess provider adherence to six IOM-recommended behaviors, we used cluster-adjusted multivariable logistic regression models including provider type (infant or toddler), race, education, and center Child and Adult Care Food Program (CACFP) participation. RESULTS: In multivariable analysis, CACFP participation was associated with providers sitting with children at meals (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2-21.7), offering fruits and vegetables (OR, 3.3; 95% CI 1.7-6.2), and limiting fast food (OR, 3.5; 95% CI, 1.8-6.7). Providers at centers serving meals family style were less likely to allow children to leave food unfinished (OR, 0.27; 95% CI, 0.09-0.77). Infant providers were more likely than toddler providers to sit with children at meals (OR, 6.98; 95% CI, 1.51-32.09), allow children to eat when hungry (OR, 3.50; 95% CI, 1.34-9.16), and avoid serving sugary (OR, 8.74; 95% CI, 3.05-25.06) or fast foods (OR, 11.56; 95% CI, 3.20-41.80). CONCLUSIONS: CACFP participation may encourage IOM-recommended feeding practices among infant and toddler providers. Child care providers may benefit from education about how to feed infants and toddlers responsively, especially when offering foods family style. Future research should explore ways to promote child-centered feeding practices, while addressing barriers to providing children with nutrient-rich foods.
BACKGROUND: Identifying characteristics associated with the Institute of Medicine's (IOM) recommended feeding practices among infant and toddler care providers in child care centers could help in preventing childhood obesity. METHODS: In 2009, at baseline in a pilot intervention study of 29 licensed Massachusetts child care centers with at least 50% of enrolled children identified as racial minorities, 57 infant and 109 toddler providers completed feeding questionnaires. To assess provider adherence to six IOM-recommended behaviors, we used cluster-adjusted multivariable logistic regression models including provider type (infant or toddler), race, education, and center Child and Adult Care Food Program (CACFP) participation. RESULTS: In multivariable analysis, CACFP participation was associated with providers sitting with children at meals (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2-21.7), offering fruits and vegetables (OR, 3.3; 95% CI 1.7-6.2), and limiting fast food (OR, 3.5; 95% CI, 1.8-6.7). Providers at centers serving meals family style were less likely to allow children to leave food unfinished (OR, 0.27; 95% CI, 0.09-0.77). Infant providers were more likely than toddler providers to sit with children at meals (OR, 6.98; 95% CI, 1.51-32.09), allow children to eat when hungry (OR, 3.50; 95% CI, 1.34-9.16), and avoid serving sugary (OR, 8.74; 95% CI, 3.05-25.06) or fast foods (OR, 11.56; 95% CI, 3.20-41.80). CONCLUSIONS: CACFP participation may encourage IOM-recommended feeding practices among infant and toddler providers. Child care providers may benefit from education about how to feed infants and toddlers responsively, especially when offering foods family style. Future research should explore ways to promote child-centered feeding practices, while addressing barriers to providing children with nutrient-rich foods.
Authors: Sheryl O Hughes; Heather Patrick; Thomas G Power; Jennifer O Fisher; Cheryl B Anderson; Theresa A Nicklas Journal: J Dev Behav Pediatr Date: 2007-04 Impact factor: 2.225
Authors: Cynthia L Ogden; Margaret D Carroll; Lester R Curtin; Margaret A McDowell; Carolyn J Tabak; Katherine M Flegal Journal: JAMA Date: 2006-04-05 Impact factor: 56.272
Authors: Lyndel Hewitt; Sara E Benjamin-Neelon; Valerie Carson; Rebecca M Stanley; Ian Janssen; Anthony D Okely Journal: Infant Behav Dev Date: 2017-12-07
Authors: Jessica S Gubbels; Kelly Stessen; Ilona van de Kolk; Nanne K de Vries; Carel Thijs; Stef P J Kremers Journal: PLoS One Date: 2018-09-07 Impact factor: 3.240
Authors: Patricia Markham Risica; Jacqueline M Karpowicz; Tayla von Ash; Kim M Gans; Kristen Cooksey-Stowers; Alison Tovar Journal: Int J Environ Res Public Health Date: 2022-08-06 Impact factor: 4.614
Authors: Jessie-Lee D McIsaac; Madison MacQuarrie; Rachel Barich; Sarah Morris; Joan C Turner; Melissa D Rossiter Journal: Int J Environ Res Public Health Date: 2022-09-20 Impact factor: 4.614
Authors: Raphael M Herr; Katharina Diehl; Sven Schneider; Nina Osenbruegge; Nicole Memmer; Steffi Sachse; Stephanie Hoffmann; Benjamin Wachtler; Max Herke; Claudia R Pischke; Anna Novelli; Jennifer Hilger-Kolb Journal: Int J Environ Res Public Health Date: 2021-05-07 Impact factor: 3.390