142nd APHA Annual Meeting and Exposition

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Examining the relationship between maternal disordered eating, depression, anxiety and mother-toddler feeding interactions among low-income mothers

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Lucine Petit Francis, BSN, RN, PhD student , School of Nursing, Johns Hopkins University, Baltimore, MD
Erin Hager, PhD , Department of Pediatrics, Growth and Nutrition Division and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
Margo Candelaria, PhD , University of Maryland School of Medicine, Baltimore, MD
Kristen Hurley, PhD, MPH , Center for Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Raquel Arbaiza, MA , Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, MD
Maureen Black, PhD , Department of Pediatrics and Department of Epidemiology and Public Health and Chief, Division of Growth and Nutrition, University of Maryland School of Medicine, Baltimore, MD
Introduction:  Poor maternal mental health has been linked to unresponsive mother-child feeding interactions, possibly increasing children’s risk for obesity. This study assesses the relationship between maternal mental health (disordered eating, depression, and anxiety) and characteristics of feeding interactions (maternal sensitivity and structuring) among low income mothers and toddlers aged 12-30 months. 

Methods:  304 low-income mother-toddler dyads were recruited from urban and suburban sites.  Mothers reported on demographics, symptoms of disordered eating (Eating Attitudes Test), depression (Beck Depression Inventory) and anxiety (Speilberger State- Trait Anxiety Inventory).   Video-taped mother-child interactions during mealtimes were coded to generate measures of maternal sensitivity and structuring using Emotional Availability Scales.  Pearson’s correlations & multiple linear regression analyses evaluated associations.

Results: Analytic sample included 86.2% (n=262); 54% male toddlers (mean age 20.2 months, 74% African-American) and 82% mothers with a high school education/higher (mean age 27.2 years).  Symptoms of maternal anxiety and disordered eating were associated with low maternal sensitivity (r=-0.149, p=0.016; r=0.168, p=0.006) and low structuring (r=-0.155, p=0.012; r=0.145, p=0.019). Maternal depressive symptoms were not associated with either dimension of toddler feeding (p>0.05). In a regression model, maternal anxiety (β=-0.284, p=0.034) and disordered eating (β =0.014, p=0.018) predicted maternal sensitivity.  Maternal anxiety (β=-0.381, p=0.004) but not disordered eating (p>0.05) predicted maternal structuring, adjusting for covariates.

Discussion: Symptoms of maternal anxiety and disordered eating are associated with risk for unresponsive mother-child feeding interactions.  Intervention efforts to reduce anxiety and disordered eating among low-income mothers with toddlers may prevent unresponsive feeding interactions, possibly reducing risk for pediatric obesity.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Environmental health sciences
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify at least 2 risk factors for unresponsive mother-child feeding interactions among low-income women. Describe the relationship between symptoms of disordered eating, anxiety, depression and child-toddler feeding interactions Name at least 1 consideration for clinical assessment of disordered eating, anxiety, depression and child-toddler feeding interactions among low-income women.

Keyword(s): Child Health, Nutrition

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a second year PhD student at Johns Hopkins University and have been involved in many research projects during undergrad, post-grad and in my PhD program. I've co-authored a paper in 2012 examining the role of Intimate Partner Violence on Disordered eating. This work was presented at the 2012 APHA by my co-author. This work being submitted is in line with my interests in toddler feeding styles and childhood obesity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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