OBJECTIVE-This study explored the relationship between food insecurity and compensatory maternal feeding practices that may be perceived as buffers against periodic food shortages among urban Black families. PATIENTS AND METHODS-We interviewed a convenience sample of Black mothers of children ages 2-13 years. Food security status (predictor) was assessed at the household level. Five maternal feeding practices (outcomes) were assessed. Two were based on Birch's Child Feeding Questionnaire (CFQ): restricting access to certain desired foods and pressuring a child to eat; and 3 were derived from investigators' clinical experience: the use of high calorie supplements, added sugar in beverages, and perceived appetite stimulants. Anthropometric data were collected from mothers and children.RESULTS-278 mother-child dyads were analyzed, and 28% of these mothers reported being food insecure. Use of CFQ feeding practices was defined as the top quartile of responses. Use of nutritional supplements, defined as "at least 1-2 times monthly", was common, ranging from 13%-25%. In logistic regression models adjusted for child age, BMI, and ethnicity and maternal BMI, mothers from food insecure households were significantly more likely to use high calorie supplements (OR, 2.1; 95% CI, 1.1-4.0) and appetite stimulants (OR, 3.2; 95% CI, 1.5-7.1). The odds of using the remaining compensatory feeding practices were elevated among food insecure households, but not reach statistical significance: adding sugars to beverages (OR, 2.1; 95% CI, 0.99-4.4), pressuring a child to eat (OR, 1.8; 95% CI, 0.98-3.2), and restricting access to certain foods (OR, 1.5; 95% CI 0.8-2.7). CONCLUSIONS-Household food insecurity was independently associated with two of the five maternal compensatory feeding practices studied. Such practices may alter the feeding environment and increase the risk of overweight in children. Longitudinal research is necessary to determine how the relationship between food security and compensatory maternal feeding practices impacts child weight trajectories.

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