Longitudinal Analysis Between Maternal Feeding Practices and Body Mass Index (BMI): A Study in Asian Singaporean Preschoolers

Abstract

Bidirectional studies between maternal feeding practices with subsequent child weight are limited

with no studies in Asian populations. In longitudinal analyses

we assessed the directionality of the associations between maternal feeding practices and body mass index (BMI) in preschoolers. Participants were 428 mother child dyads from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort. Feeding practices were assessed using the Comprehensive Feeding Practices Questionnaire (CFPQ) at age 5 y. Child BMI was measured at ages 4 and 6 y. BMI and maternal feeding practices subscales were transformed to SD scores and both directions of their associations examined with multivariable linear regression and pathway modeling. Higher BMI at age 4 was associated with lower encouragement of balance and variety (beta = -0.33; 95% CI: -0.53

-0.13)

lower pressure to eat (beta = -0.49; -0.68

-0.29) and higher restriction (beta = 1.10; 0.67

1.52) at age 5

adjusting for confounders and baseline feeding practices at 3 years. In the reverse direction

only pressure and restriction at age 5 were associated with lower and higher child BMI at age 6 years

respectively. After the adjustment for baseline BMI at age 5

the association with pressure was attenuated to non-significance (beta = 0.01 (-0.01

0.03)

while the association with restriction remained significant (beta = 0.02; 0.002

0.03). Overall

associations from child BMI to maternal restriction for weight control and pressure feeding practices was stronger than the association from these maternal feeding practices to child BMI (Wald's statistics = 24.3 and 19.5

respectively; p < 0.001). The strength and directionality suggests that the mothers in the Asian population were likely to adopt these feeding practices in response to their child's BMI

rather than the converse.