Top Things to Know: Caregiver Influences on Eating Behaviors in Young Children
Published: May 11, 2020
- Feeding children is a reciprocal process that depends on the abilities of the caregiver and the child.
- Pre-pregnancy obesity, maternal diet, and excess weight gain during pregnancy are all associated with increased risk of obesity among offspring, substantiating research that what a woman eats during pregnancy influences children’s taste preferences (with effects that can occur across their lifetime) and possibly their growth via effects on appetite.
- To maintain good eating self-regulation in children, current research suggests that a caregiver’s overarching goal should be to allow children autonomy over their eating, starting and stopping eating in response to their hunger and satiation.
- Caregivers should have knowledge of infant hunger (such as opening mouth wide or settling into the feed) and satiety cues (such as taking interest in surroundings, decreased activity level, pulling away abruptly or detaching from the nipple, and falling asleep); they should be able to distinguish these from non-appetite related cues.
- The challenge for caregivers is to provide structure and boundaries without decreasing a child’s eating autonomy to the extent (s)he no longer self-regulates eating, but instead looks to external factors to cue eating.
- A strong evidence base suggests that children’s eating self-regulation is best supported when caregivers provide a feeding environment which covertly sets boundaries around food, such as meal timing and the types of foods provided to eat.
- Caregivers should be responsive to children’s hunger and fullness cues, paying attention to children’s verbal and non-verbal signals and not pressuring children to eat more than they wish.
- In preschool, more supportive approaches, such as questions, suggestions, and offering choices within a structured environment are associated with better eating self-regulation and growth trajectories. A structured environment limits the types of food available and the timing of meals rather than placing limits on the child’s eating behaviors.
- Caregivers are encouraged not to focus on what, or how much, a child eats. Rather, a varied diet is encouraged via environmental structure such as the consistent and repeated offering of healthy foods to children, the use of “preferred” foods (such as a dip), and caregivers enthusiastically consuming the food themselves.
- An appropriate structure around food can be set to not focus on child behavior specifically, but instead provide rules and limits around children’s meals via consistent snack routines, timing of meals, and selective availability of foods in the home.
Citation
Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Epidemiology and Prevention; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; and Stroke Council. Caregiver influences on eating behaviors in young children: a scientific statement from the American Heart Association. J Am Heart Assoc. 2020;9:e014520. DOI: 10.1161/jaha/119.014520