The Feeding Practices and Structure Questionnaire: development and validation of age appropriate versions for infants and toddlers

Abstract

Background: A large range of questionnaires is available to assess parental feeding practices. Most have been developed for and are used with children aged two years and older. To measure and better understand trajectories of feeding and their relationship with child eating behaviours and weight in the long term, assessment from infancy is desirable. While questionnaires also exist to measure feeding practices of parents with infants, no questionnaire is available that allows tracking of feeding practices across time, from infancy through childhood. The aim of the study was to develop a version of the Feeding Practices and Structure Questionnaire (FPSQ) for parents with infants and toddlers.Methods: Constructs and items for the FPSQ for infants and toddlers were derived from the existing and validated FPSQ for older children and supplemented by a review of the literature on infant feeding questionnaires. Following expert review, two versions of the questionnaire were developed, one for milk feeding parents and one for solid feeding parents. Data from two studies were combined (child ages 0-24 months) to test the derived constructs with Confirmatory Factor Analysis for the milk feeding (N=731) and solid feeding (N=611) versions. Results: The milk feeding version consisted of four factors (18 items) and showed acceptable model fit and good internal reliability: ‘feeding on demand vs. feeding routine’ (α= 0.87), ‘using food to calm’ (α= 0.87), ‘persuasive feeding’ (α= 0.71), ‘parent-led feeding’ (α= 0.79). The same four factors showed acceptable model fit for the solid feeding version (21 items), likewise with good internal reliability (α= 0.74, 0.86, 0.85, 0.84 respectively). Two additional factors (13 items) were developed for the solid feeding version that appeared developmentally appropriate only for children aged 12 months or older: ‘family meal environment’ (α= 0.81) and ‘using (non-)food rewards’ (α= 0.92). The majority of factor-factor correlations were in line with those of the original FPSQ.Conclusions: The FPSQ milk and solid feeding versions are the first measures specifically developed as precursors to the FPSQ to measure parental feeding practices in children <2 years, particularly those related to non-responsiveness and structure. Further validation in more diverse samples is required.MeSH terms:Infant, Feeding behaviour, Parents, Body weight