Caregiver beliefs as determinants of feeding practices among older infants and toddlers in the WIC Program

Introduction: Much of the research related to the contributions of caregiver feeding styles and child overweight has been conducted among preschoolers. However, these feeding practices are likely to begin much earlier. In this study, WIC participants were asked about their decision-making processes surrounding feeding of infants from 7 to 18 months of age. Methods: In focus groups, a semi-structured discussion was used to identify attitudes, beliefs, and events that may trigger inappropriate feeding practices among caregivers of older infants and toddlers (7-18 months). A total of 10 English language focus groups (n=81) and 6 Spanish language focus groups (n=41) were conducted. All groups were recorded, transcribed, and supplemented with field notes. Transcripts were analyzed independently by 4 researchers and differences were resolved by consensus. Results: As in our earlier studies, parents' feeding decisions often were made in response to their interactions with their infants. Disparities between parents' expectations for child behavior and age-related developmental norms resulted in inappropriate feeding practices and attempts to control behavior with food. Parents described an intense belief that their children “must” eat; therefore they had no choice but to deviate from guidelines and engage in inappropriate practices. Feeding was also used to control specific child behaviors. Discussion: Feeding practices and styles that may increase children's risk for subsequent obesity may develop when caregivers attempt to address unexpected, but developmentally normal infant and toddler behaviors . Interventions are needed to improve parents' knowledge of child development before poor feeding practices occur.