Common Feeding Practices Used by Chinese Caregivers of 6-10-Month-Old Infants: A Behavioral Observation Study in Shaanxi Province

J Nutr Educ Behav. 2024 Sep 19:S1499-4046(24)00417-2. doi: 10.1016/j.jneb.2024.07.012. Online ahead of print.

Abstract

Objective: To explore the feeding practices and feeding environment of Chinese families with 6-10-month-old infants.

Design: One day of caregiver-recorded feeding occasions.

Setting: Homes in Shaanxi, China.

Participants: Families recruited using convenience sampling.

Variables measured: Videos were coded for feeding practice frequency and acceptance rate, feeding environment, and responsiveness to infant fullness cues and eating pace.

Analysis: Wilcoxon rank sum tests examined the differences in feeding practice use based on caregiver type, infant sex, and infant weight status.

Results: Twenty-eight families provided videos for coding. The most commonly observed feeding practices were opening the mouth, giving instructions, and interfering with the child's actions. Prompts to eat were accepted 86.9% of the time. Overweight infants' caregivers used significantly more coercive prompts to eat than did caregivers of healthy-weight infants (P < 0.05). Mothers used more autonomy-supportive prompts to eat than did fathers (P < 0.05). Early, active, and late infant fullness cues were captured in 25.6%, 34.8%, and 8.5% of videos, respectively. 53.6% of caregivers fed at the right pace, whereas 14.5% and 31.9% fed too slow or too fast, respectively. Approximately 5.5% of videos had a screen on, and 33.5% of videos included at least 1 other distraction during the meal.

Conclusions and implications: Differences in feeding practices among caregivers suggest that targeted advice may further improve feeding practices. Improving the caregiver's ability to identify satiety cues and respond to infant eating speed may also reduce the risk of overfeeding.

Keywords: behavioral observation; feeding environment; feeding practices; infant feeding; responsive feeding.