A mixed methods study of siblings’ roles in maternal feeding practices in early childhood: an application of the learning from experience process

Understanding pathways from feeding difficulties of children to mental health risks of mothers at critical stages of childrearing: Does social support make a difference?

Background

Identifying the factors influencing mental health of mothers at critical stages of childrearing is significant for the implementation of effective promotion policies and counselling activities.

Objective

This study aimed to investigate the relationships between children's feeding difficulties, marital quality, parenting quality and maternal mental health risks amidst Chinese mothers with high and low social support using a multi-group structural equation modelling approach.

Participants

A cross-sectional study was conducted in Wenzhou, China and a total of 772 mothers with children aged 0-3 were surveyed by using purposive sampling.

Findings

Results showed that of the 772 participants, 23.6 % reported anxiety, 50.1 % reported depression, 91.2 % reported insomnia, and 24 % reported feeding difficulties. The joint occurrence of multiple forms of mental problems is the most commonly reported features of mental health risks among mothers. The positive association between feeding difficulties of children and mental health risks of mothers was mediated by marital quality and parenting quality. In addition, feeding difficulties were not related to mental health risks in high social support group but all the relationships were significant in low social support group.

Conclusions

These findings highlight the importance of the specific interventions to enhance social support, marital quality and parenting quality for improving mental health of mothers of children with feeding difficulties.

The feeding siblings questionnaire (FSQ): Development of a self-report tool for parents with children aged 2-5 years

Over the last decade, there have been repeated calls to expand the operationalisation of food parenting practices. The conceptualisation and measurement of these practices has been based primarily on research with parent-child dyads. One unexplored dimension of food parenting pertains to the evaluation of practices specific to feeding siblings. This study describes the development and validation of the Feeding Siblings Questionnaire (FSQ) - a tool designed to measure practices in which siblings are positioned as mediators in parents' attempts to prompt or persuade a child to eat. Item development was guided by a conceptual model derived from mixed-methods research and refined through expert reviews and cognitive interviews. These interviews were conducted in two phases, where parents responded to the questionnaire primarily to test i) the readability and relevance of each item, and ii) its overall feasibility. The instrument was completed by 330 parents (96.1% mothers) in Australia with two children aged 2-5 years, and repeated by 133 parents (40.3%) two weeks later. Exploratory factor analysis was performed on baseline data. Internal consistency and test re-test reliability of the subsequent subscales were examined. Construct validity was assessed through comparisons with existing measures of food parenting practices and child eating behaviours. The final FSQ scale included 22 items, reflecting five food parenting practices: sibling competitiveness, active sibling influence, threatening unequal division of food, sibling role modelling, and vicarious operant conditioning. Internal consistency and test re-test reliability estimates were high, and there was some evidence of convergent construct validity. While its factor structure should be confirmed in a different sample, the FSQ offers a novel tool for assessing, monitoring, and evaluating feeding interactions beyond those confined to the parent-child dyad.

Direct Sibling Influence on Eating Behavior in Early Childhood: Siblings as Role Models and Caregivers

OBJECTIVE

Despite the majority of US children having at least 1 sibling, little is known about how siblings influence eating behavior and obesity risk. This qualitative study explored mothers' perceptions of older siblings' influences on younger siblings' eating behavior in the context of mealtimes in early childhood.

METHODS

A purposive subsample of mothers (n = 30) who participated in the Intervention Nurses Start Infants Growing on Healthy Trajectories and SIBSIGHT studies completed retrospective semi-structured interviews designed to explore the implications of sibling influences on maternal feeding practices during infancy and toddlerhood. Interviews were conducted by video conference with mothers between January and March 2021. All interviews were audio-recorded, transcribed, and a qualitative content analysis approach was used to code and identify themes.

RESULTS

Two main themes were identified related to the influence of older siblings on younger siblings during feeding interactions: 1) Older siblings as positive role models for younger siblings and 2) Older siblings acted as caregivers for younger siblings. Younger siblings received encouragement at mealtimes to try new foods. Older siblings assisted their mothers in caregiving and feeding tasks in developmentally appropriate ways.

CONCLUSIONS

Findings may help to elucidate the role of older siblings in shaping eating behavior and obesity risk of siblings in early childhood. Better understanding the role of siblings can aid in the development of novel interventions and anticipatory nutrition guidance in family-based clinical and community care.

'I'm having jelly because you've been bad!': A grounded theory study of mealtimes with siblings in Australian families

Obesity prevention interventions have been designed to promote responsive feeding in early childhood. However, existing interventions primarily target first-time mothers without considering the complexities of feeding multiple children within a family unit. By applying principles of Constructivist Grounded Theory (CGT), this study aimed to explore how mealtimes are enacted in families with more than one child. A mixed-methods study was conducted with parent-sibling triads (n = 18 families) in South East Queensland, Australia. Data included direct mealtime observations, semistructured interviews, field notes, and memos. Data were analysed using open and focused coding, during which constant comparative analysis was applied. The sample comprised of two-parent families with children ranging in age from 12 to 70 months (median sibling age difference = 24 months). A conceptual model was developed to map sibling-related processes integral to the enactment of mealtimes in families. Notably, this model captured feeding practices used by siblings, such as pressure to eat and overt restriction, that previously had only been described in parents. It also documented feeding practices used by parents that may occur only in the presence of a sibling, such as leveraging sibling competitiveness and rewarding a child to vicariously condition their sibling's behaviour. The conceptual model demonstrates complexities in feeding that give shape to the overall family food environment. Findings from this study can inform the design of early feeding interventions that support parents to remain responsive, particularly when their perceptions and expectations of siblings differ.