Parent-child mealtime interactions associated with toddlers' refusals of novel and familiar foods.

Parents' feeding practices have been associated with children's dietary quality and food acceptance, but previous studies have largely relied exclusively on questionnaires to assess both parent and child behavior. The current study explored the relationships between parents' reported and observed feeding practices and toddlers' food refusals. Sixty families with toddlers (12-36months-old) video recorded their children's dinners at home as well as a separate meal in which they offered the child a novel fruit or vegetable. Parents completed questionnaires about their feeding practices and children's picky eating and food neophobia. Videos were coded for parents' observed feeding practices at mealtimes and children's food refusals. Parents' feeding practices and children's food refusals were compared in families with children reported to be more picky and less picky eaters. The relationships between reported and observed feeding practices with observed food refusals were also assessed. It was hypothesized that parents' use of controlling and coercive prompts to eat would be associated with children's food refusals. Parent-reported picky eating was not associated with an increase in children's total food refusals, although reported neophobia was associated with more uses of crying, pushing food away, or verbally refusing a new food. More prompts to eat of any kind were associated with more food refusals. In regression models, more observed coercive-controlling prompts used by parents were associated with more food refusals by children. Parents of pickier eaters tended to use a lower proportion of autonomy-supportive prompts to eat, and these families also showed a stronger association between the use of controlling prompts and food refusals. These families may benefit the most from interventions aiming to reduce the use of controlling practices. Models using observed feeding practices were more strongly associated with children's food refusals than were parents' reported feeding practices. This highlights the importance of behavioral observation in this field.