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Caregiver verbal encouragement increases food acceptance among Vietnamese toddlers.

ABSTRACT: Responsive feeding, defined as the positive environment and caregiving behaviors that encourage children to eat, is critical to their physical, mental, and social development. However, research and programs designed to foster responsive feeding have been limited. This research tested the hypothesis that caregiver encouragement, caregiver and child behaviors, and other feeding characteristics were associated with acceptance of food. A total of 91 mother/child pairs in rural, northern Vietnam were videotaped during 2 2-h feeding episodes. Children were 12 and 17 mo of age at the time of study. Caregiver and child behaviors were coded at the level of the "intended bite" (7135 bites total). Feeding episodes were marked by few physical actions and minimal verbal encouragement by caregivers. Results from generalized linear mixed models suggest that when caregivers provided children with positive comments, children were 2.4 times as likely to accept bites compared with when no comments were given. Twelve-mo-olds who were in the caregiver's arms [odds ratio (OR) = 0.5] or lap (OR = 0.5) were significantly less likely than those who stood to accept bites. The 17-mo-olds who played were less likely than those with no physical action to accept bites. Play appeared to distract boys more than girls. In Vietnam, programs should help caregivers provide positive verbal encouragement to eat. Program planners and implementers may want to encourage caregivers to avoid force feeding and other forms of physical pressure. Further, mealtime should be seen as an opportunity to develop long-term feeding skills and encourage a healthy appetite.

SUBMITTER: Dearden KA

PROVIDER: S-EPMC6459056 | biostudies-literature | 2009 Jul

REPOSITORIES: biostudies-literature

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Caregiver verbal encouragement increases food acceptance among Vietnamese toddlers.

Dearden Kirk A KA Hilton Sterling S Bentley Margaret E ME Caulfield Laura E LE Wilde Cathleen C Ha Pham Bich PB Marsh David D

The Journal of nutrition 20090513 7

Responsive feeding, defined as the positive environment and caregiving behaviors that encourage children to eat, is critical to their physical, mental, and social development. However, research and programs designed to foster responsive feeding have been limited. This research tested the hypothesis that caregiver encouragement, caregiver and child behaviors, and other feeding characteristics were associated with acceptance of food. A total of 91 mother/child pairs in rural, northern Vietnam were ...[more]

PMID: 19439464

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Project description:BackgroundDeveloping age-appropriate medications remains a challenge in particular for the population of infants and toddlers, as they are not able to reliably self-report if they would accept and consequently take an oral medicine. Therefore, it is common to use caregivers as proxies when assessing medicine acceptance. The outcome measures used in this research field differ and most importantly lack validation, implying a persisting gap in knowledge and controversy in the field. The newly developed Caregiver-administered Children's Acceptance Tool (CareCAT) is based on a 5-point nominal scale, with descriptors of medication acceptance behavior. This cross-sectional study assessed the measurement properties of the tool with regards to the user's understanding and its intra- and inter-rater reliability.MethodsParticipating caregivers were enrolled at a primary healthcare facility where their children (median age 6 months) had been prescribed oral antibiotics. Caregivers, trained observers and the tool developer observed and scored on the CareCAT tool what behavior children exhibited when receiving the medicine (n = 104). The video-records of this process served as replicate observations (n = 69). After using the tool caregivers were asked to explain their observations and the tool descriptors in their own words. The tool's reliability was assessed by percentage agreement and Cohen's unweighted kappa coefficients of agreement for nominal scales.ResultsThe study found that caregivers using CareCAT had a satisfactory understanding of the tool's descriptors. Using its dichotomized scores the tool reliably was strong for acceptance behavior (agreement inter-rater 84-88%, kappa 0.66-0.76; intra-rater 87-89%, kappa 0.68-0.72) and completeness of medicine ingestion (agreement inter-rater 82-86%, kappa 0.59-0.67; intra-rater 85-93%, kappa 0.50-0.70).ConclusionsThe CareCAT is a low-cost, easy-to-use and reliable instrument, which is relevant to assess acceptance behavior and completeness of medicine ingestion, both of which are of significant importance for developing age-appropriate medications in infants and toddlers.

Project description:BackgroundThe prevalence of obesity and type 2 diabetes continues to increase. These conditions disproportionately affect minorities and are associated with poor nutrition early in life. Current food-consumption patterns can inform pending dietary guidelines for infants and toddlers.ObjectiveThe aim of this study was to describe infant feeding, complementary feeding, and food and beverage consumption patterns of 0- to 23.9-mo-olds in the general population.MethodsThe Feeding Infants and Toddlers Study 2016 is a cross-sectional survey of caregivers of children aged <4 y. Dietary data were collected from a national random sample by using a 24-h dietary recall (n = 3235). The percentage of children consuming foods from >400 food groups was calculated. Differences in the percentage consuming between Hispanic, non-Hispanic white, and non-Hispanic black children aged 0-23.9 mo were evaluated with the use of ORs and 95% CIs.ResultsEighty-three percent of 0- to 23.9-mo-olds (n = 2635) were ever breastfed, 34% of 0- to 3.9-mo-olds (n = 305) and 15% of 4- to 5.9-mo-olds (n = 295) were exclusively breastfed, and 24% of 12- to 14.9-mo-olds (n = 412) consumed breast milk on the day of the recall. Complementary foods were more likely to be introduced before 4 mo in formula-fed infants (27%) than in infants who did not consume formula (5%). Half of 4- to 5.9-mo-olds consumed iron-fortified infant cereal, but few consumed iron-rich meats. Among toddlers (12-23.9 mo; n = 1133), >20% consumed no servings of fruit or vegetables on the day of the recall, approximately half consumed 100% fruit juice, and one-quarter to one-third consumed a sugar-sweetened beverage (SSB).ConclusionsBreastfeeding initiation and duration have improved, but exclusivity remains low. Low consumption of iron-rich foods, fruit, and vegetables and lack of variety in vegetable consumption are problems. Efforts to reduce the consumption of SSBs and 100% fruit juice are warranted in early childhood.

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Caregiver verbal encouragement increases food acceptance among Vietnamese toddlers.

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Caregiver verbal encouragement increases food acceptance among Vietnamese toddlers.

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