Maternal characteristics influence infant feeding styles in Caribbean women

Abstract

Objective: To examine associations between maternal characteristics and feeding styles in Caribbean mothers. Design: Participants were mother-child pairs enrolled in a cluster randomized trial of a parenting intervention in 3 Caribbean islands. Maternal characteristics were obtained by questionnaires when infants were 6-8 weeks old. Items adapted from the Toddler Feeding Behaviour Questionnaire were used to assess infant feeding styles at age 1 year. Feeding styles were identified using factor analysis and associations with maternal characteristics assessed using multilevel linear regression. Setting: Health clinics in St. Lucia (n=9), Antigua (n=10) and Jamaica (n=20). Participants: 405 mother-child pairs from the larger trial. Results: Maternal depressive symptoms were associated with uninvolved (β= 0.38 [95%CI=0.14, 0.62]), restrictive (β= 0.44 [95%CI= 0.19, 0.69]) and forceful (β=0.31 [95%CI= 0.06, 0.57]) feeding; and inversely associated with responsive feeding (β= −0.30 [95%CI= −0.56, −0.05]).Maternal vocabulary was inversely associated with uninvolved (β= −0.31 [95%CI= −0.57, −0.06]), restrictive (β= −0.30 [95%CI= −0.56, −0.04]), indulgent (β= −0.47 [95%CI= −0.73, −0.21]) and forceful (β= −0.54 [95%CI= −0.81, −0.28]) feeding. Indulgent feeding was negatively associated with socioeconomic status (β= −0.27 [95%CI= −0.53, −0.00]) and was lower among mothers ≥35 years (β= −0.32 [95%CI= −0.62, −0.02]). Breastfeeding at 1 year was associated with forceful feeding (β= 0.41 [95%CI= 0.21, 0.61]). No significant associations were found between maternal education, body mass index, occupation and feeding styles. Conclusion: Services to identify and assist mothers with depressive symptoms may benefit infant feeding style. Interventions to promote responsive feeding may be important for, less educated, younger and socioeconomically disadvantaged mothers.

Maternal feeding styles and the risk of overweight in a cohort of Caribbean infants

“…Internal validity of the questionnaire was assessed using Cronbach's (α) alpha coefficients for each feeding style subscale. Cronbach's alphas were ≥0.70; demonstrating satisfactory internal consistencies for each feeding dimension 31 . The feeding style questionnaire was interviewer administered when mothers attended the health centre for their infants 12‐month clinic visit.…”

“…Intra-class correlation coefficients were ≥0.62 for all items. 31 Internal validity of the questionnaire was assessed using Cronbach's (α) alpha coefficients for each feeding style subscale. Cronbach's alphas were ≥0.70;…”

“…Mothers with depression were less responsive to their children during mealtimes, thereby limiting the ability of the mother to react appropriately 30 . We have previously shown that maternal depressive symptoms were related to higher non‐responsive styles of feeding and a reduction in responsive feeding 31 …”

“…30 We have previously shown that maternal depressive symptoms were related to higher non-responsive styles of feeding and a reduction in responsive feeding. 31 Much of the literature on the association between maternal feeding styles and children with overweight is cross sectional; as such the directionality of the association is unclear. Moreover, most of these studies were conducted in high-income countries and with children aged 3 and older.…”

Maternal depressive symptoms and physical intimate partner violence and children’s internalizing and externalizing behaviors in Guyanese families: Mediating role of constructive conflict behavior.

“…Research on the impact of mental health disorders and different forms of family violence on children's emotional functioning in the Caribbean region, more so in Guyana, is limited (see Krishnakumar, 2021). What meagre data exist on Caribbean families indicate that maternal depression in Haitian families was not related to developmental difficulties in malnourished children (She et al, 2022), it had a direct negative association with Jamaican children's behavior problems in school (Kirsch et al, 2002) and was negatively related to uninvolved, restrictive, forceful feeding of infants in Antigua, Jamaica, and St. Lucia (Wright et al, 2021). At the same time, the co-occurrence of physical punishment and physical intimate partner violence was related to childhood aggression in Jamaican children (Bott et al, 2021), and a history of childhood maltreatment and witnessing intimate partner violence adversely affected mental health later in life among Black Caribbean women residing in the United States (Lacey et al, 2021).…”