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APHA Scientific Session and Event Listing

Recorded presentation

Emily Feinberg, ScD, CPNP¹, Nicole Prudent, MD, MPH², Mario Malivert, MD, MPH³, Marie Foureau, MD³, and Patricia Kavanagh, MD². (1) Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany Street, T5W, Boston, MA 02118, (2) Department of Pediatrics, Boston Medical Center, 91 East Concord St, Boston, MA 02118, 617 414-3573, patricia.kavanagh@bmc.org, (3) Haitian Health Institute, Boston Medical Center, Harrison Ave., Boston, MA 02118

Background: To better understand antecedents to childhood overweight, researchers have focused on maternal feeding practices that may increase risk of child overweight. Household food insecurity is associated with overweight in adult women and certain subpopulations of children. However, how food insecurity impacts maternal feeding practices has not been studied. Objective: To examine the relationship between food insecurity and maternal feeding practices that may increase risk of child overweight. Design/Methods: Using a questionnaire adapted from Birch s Child Feeding Questionnaire, we interviewed 248 mothers of normal and overweight Haitian and African American children, ages 2-12. We examined 4 at-risk feeding practices: 2 identified by Birch (pressuring a child to eat and restricting a child s intake) and 2 identified from clinical experience (use of supplements to increase calories - e.g. Pediasure, Carnation Instant Breakfast, adding sugar to milk and juice, and use of substances that the mother believed would stimulate the child s appetite. Food insecurity was measured using the U.S. Household Food Security Measure Short Form. Multivariate logistic regression was used to explore the relationship between maternal feeding practices and food insecurity, controlling for potential confounders. Results: 28% of the sample was food insecure, with significantly more Haitian families experiencing food scarcity. Routine use of calorie boosters and perceived appetite stimulants were used by 43% and 12% of the sample, respectively. In multivariate models, mothers in food insecure households had approximately twice the odds of giving their child foods to boost calories (OR 1.91, 95% CI 1.03, 3.52) or stimulate the appetite (OR 2.44, 95% CI 1.08, 5.48), controlling for ethnicity, child age, and maternal and child weight. Food insecurity was not associated with at-risk feeding practices identified by Birch (pressure to eat and restriction). Conclusions: Our findings suggest that household food insecurity may alter the feeding environment in ways that increase risk of childhood overweight. They also highlight the prevalence of ethnically-specific feeding practices.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe 4 at-risk feeding practices that increase risk of childhood overweight
• Discuss how food insecurity impacts maternal feeding practices
• Recognize the role of culture/ethnicity in shaping maternal feeding practices

Keywords: Food Security, Ethnic Minorities

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation