Effect of a responsive parenting intervention on child emotional overeating is mediated by reduced maternal use of food to soothe: The INSIGHT RCT

Abstract

Summary Background Child emotional overeating is a risk factor for obesity that is learned in the home environment. Parents' use of food to soothe child distress may contribute to the development of children's emotional overeating. Objectives To examine the effect of a responsive parenting (RP) intervention on mother‐reported child emotional overeating, and explore whether effects are mediated by mother‐reported use of food to soothe child distress. Methods The sample included primiparous mother‐infant dyads randomized to a RP intervention (n = 105) or home safety control group (n = 102). Nurses delivered RP guidance in four behavioral domains: sleeping, fussy, alert/calm, and drowsy. Mothers reported their use of food to soothe at age 18 months and child emotional overeating at age 30 months. Mediation was analyzed using the SAS PROCESS macro. Results RP intervention mothers reported less frequent use of food to soothe and perceived their child's emotional overeating as lower compared to the control group. Food to soothe mediated the RP intervention effect on child emotional overeating (mediation model: R2 = 0.13, P < .0001). Conclusions Children's emotional overeating may be modified through an early life RP intervention. Teaching parents alternative techniques to soothe child distress rather than feeding may curb emotional overeating development to reduce future obesity risk.

Barriers and enablers to caregivers' responsive feeding behaviour: A systematic review to inform childhood obesity prevention

“…The majority of studies were conducted in the USA ( n = 20), 24–43 followed by Australia ( n = 10), 44–53 United Kingdom ( n = 8), 54–61 New Zealand ( n = 1), 62 Norway ( n = 2), 63,64 and Sweden ( n = 1) 65 . Thirty‐four studies, reported in 33 papers, employed a quantitative design, including RCTs of an intervention ( n = 5), 32,39,50,62,63 observational cohort studies ( n = 8), 24,27–29,35,54,59,60 cross‐sectional studies ( n = 11), 24,30,38,41–44,46,48,53,64 a case–control study, 26 a within‐subject experimental study, 40 a quasi‐experimental study, 51 and observational descriptive/measurement development 31 . Six studies undertook secondary analyses; two used cross‐sectional data, 25,37 two studies used data from observational cohort studies, 33,45 one used control group data, 34 and one used data from an RCT 36 .…”

“…Only one qualitative paper failed to meet the MMAT criteria for screening 56 : the majority clearly addressed the research questions 47,52,55,57,58,61,65 and derived their findings adequately from the data 47,49,52,55,57,58,61 . The randomised trials all conducted appropriate randomization and had comparable groups at baseline 32,36,39,50,62,63 . Three of the trials had low follow‐up, 32,39,63 and some of the included papers 32,36,39,50,62 did not report whether participants adhered to the assigned intervention, although this may have been reported elsewhere.…”

“…The randomised trials all conducted appropriate randomization and had comparable groups at baseline 32,36,39,50,62,63 . Three of the trials had low follow‐up, 32,39,63 and some of the included papers 32,36,39,50,62 did not report whether participants adhered to the assigned intervention, although this may have been reported elsewhere. The quantitative non‐randomised studies all included participants who were representative of the target population 28,30,31,40,41,51 .…”

“…The influence of psychological capability on responsive feeding was identified in 17 studies 32,36,39,43,47,49–52,55–58,61–63,65 . Four barriers and enablers were identified related to psychological capability: (1) responsive feeding skills; (2) knowledge and understanding of feeding, appetite, and nutrition; (3) caregiver attitude to who controls feeding; and (4) education to support responsive feeding.…”

“…Educational information and support interventions for parents were identified in six randomised controlled trials 32,36,39,50,62,63 and could be a barrier 63 or an enabler 32,36,39,50,62 . The FAB (Food, Activity, and Breastfeeding) intervention, which included additional support and education around breastfeeding, feeding, and activity over the first 18 months of an infant's life, was associated with mothers exerting less pressure to eat on their infants and allowing infants more control over their eating, relative to usual care control conditions 62 .…”