Child Care Provider Adherence to Infant and Toddler Feeding Recommendations: Findings from the Baby Nutrition and Physical Activity Self-Assessment for Child Care (Baby NAP SACC) Study

Overview

Journal Child Obes

Publisher Mary Ann Liebert

Specialties Endocrinology
Pediatrics

Date 2015 Apr 29

PMID 25918873

Citations 16

Authors

Rachel E Blaine

Kirsten K Davison

Kathryn Hesketh

Elsie M Taveras

Matthew W Gillman

Sara E Benjamin Neelon

Affiliations

Soon will be listed here.

Abstract

Background: Identifying characteristics associated with the Institute of Medicine's (IOM) recommended feeding practices among infant and toddler care providers in child care centers could help in preventing childhood obesity.

Methods: In 2009, at baseline in a pilot intervention study of 29 licensed Massachusetts child care centers with at least 50% of enrolled children identified as racial minorities, 57 infant and 109 toddler providers completed feeding questionnaires. To assess provider adherence to six IOM-recommended behaviors, we used cluster-adjusted multivariable logistic regression models including provider type (infant or toddler), race, education, and center Child and Adult Care Food Program (CACFP) participation.

Results: In multivariable analysis, CACFP participation was associated with providers sitting with children at meals (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2-21.7), offering fruits and vegetables (OR, 3.3; 95% CI 1.7-6.2), and limiting fast food (OR, 3.5; 95% CI, 1.8-6.7). Providers at centers serving meals family style were less likely to allow children to leave food unfinished (OR, 0.27; 95% CI, 0.09-0.77). Infant providers were more likely than toddler providers to sit with children at meals (OR, 6.98; 95% CI, 1.51-32.09), allow children to eat when hungry (OR, 3.50; 95% CI, 1.34-9.16), and avoid serving sugary (OR, 8.74; 95% CI, 3.05-25.06) or fast foods (OR, 11.56; 95% CI, 3.20-41.80).

Conclusions: CACFP participation may encourage IOM-recommended feeding practices among infant and toddler providers. Child care providers may benefit from education about how to feed infants and toddlers responsively, especially when offering foods family style. Future research should explore ways to promote child-centered feeding practices, while addressing barriers to providing children with nutrient-rich foods.

Citing Articles

Children's behaviour and childhood obesity.

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Infant and young child feeding practices and the factors that influence them: a qualitative study.

Weber M, Palmer W, Griffin M, Welsh J J Health Popul Nutr. 2023; 42(1):32.

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Carr T, Thompson A, Benjamin-Neelon S, Wasser H, Ward D Appetite. 2023; 183:106449.

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A Systematic Review of Research on Non-Maternal Caregivers' Feeding of Children 0-3 Years.

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Responsive Environments in Childcare Settings: A Scoping Review of the Factors Influencing Implementation and Sustainability.

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References

Nicklas T, Baranowski T, Baranowski J, Cullen K, Rittenberry L, Olvera N . Family and child-care provider influences on preschool children's fruit, juice, and vegetable consumption. Nutr Rev. 2001; 59(7):224-35. DOI: 10.1111/j.1753-4887.2001.tb07014.x. View

Dev D, McBride B, Speirs K, Donovan S, Cho H . Predictors of head start and child-care providers' healthful and controlling feeding practices with children aged 2 to 5 years. J Acad Nutr Diet. 2014; 114(9):1396-403. DOI: 10.1016/j.jand.2014.01.006. View

Stein R, Epstein L, Raynor H, Kilanowski C, Paluch R . The influence of parenting change on pediatric weight control. Obes Res. 2005; 13(10):1749-55. DOI: 10.1038/oby.2005.213. View

Addessi E, Galloway A, Visalberghi E, Birch L . Specific social influences on the acceptance of novel foods in 2-5-year-old children. Appetite. 2005; 45(3):264-71. DOI: 10.1016/j.appet.2005.07.007. View

Ogden C, Carroll M, Curtin L, McDowell M, Tabak C, Flegal K . Prevalence of overweight and obesity in the United States, 1999-2004. JAMA. 2006; 295(13):1549-55. DOI: 10.1001/jama.295.13.1549. View

Hughes S, Patrick H, Power T, Fisher J, Anderson C, Nicklas T . The impact of child care providers' feeding on children's food consumption. J Dev Behav Pediatr. 2007; 28(2):100-7. DOI: 10.1097/01.DBP.0000267561.34199.a9. View

Benjamin S, Ammerman A, Sommers J, Dodds J, Neelon B, Ward D . Nutrition and physical activity self-assessment for child care (NAP SACC): results from a pilot intervention. J Nutr Educ Behav. 2007; 39(3):142-9. DOI: 10.1016/j.jneb.2006.08.027. View

Barlow S . Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007; 120 Suppl 4:S164-92. DOI: 10.1542/peds.2007-2329C. View

Ward D, Hales D, Haverly K, Marks J, Benjamin S, Ball S . An instrument to assess the obesogenic environment of child care centers. Am J Health Behav. 2007; 32(4):380-6. DOI: 10.5555/ajhb.2008.32.4.380. View

10.

Sigman-Grant M, Christiansen E, Branen L, Fletcher J, Johnson S . About feeding children: mealtimes in child-care centers in four western states. J Am Diet Assoc. 2008; 108(2):340-6. DOI: 10.1016/j.jada.2007.09.006. View

11.

Lumeng J, Kaplan-Sanoff M, Shuman S, Kannan S . Head Start teachers' perceptions of children's eating behavior and weight status in the context of food scarcity. J Nutr Educ Behav. 2008; 40(4):237-43. DOI: 10.1016/j.jneb.2007.07.001. View

12.

Taveras E, Hohman K, Price S, Gortmaker S, Sonneville K . Televisions in the bedrooms of racial/ethnic minority children: how did they get there and how do we get them out?. Clin Pediatr (Phila). 2009; 48(7):715-9. DOI: 10.1177/0009922809335667. View

13.

Thompson A, Mendez M, Borja J, Adair L, Zimmer C, Bentley M . Development and validation of the Infant Feeding Style Questionnaire. Appetite. 2009; 53(2):210-21. PMC: 3130353. DOI: 10.1016/j.appet.2009.06.010. View

14.

Whitaker R, Gooze R, Hughes C, Finkelstein D . A national survey of obesity prevention practices in Head Start. Arch Pediatr Adolesc Med. 2009; 163(12):1144-50. DOI: 10.1001/archpediatrics.2009.209. View

15.

Berge J, Wall M, Loth K, Neumark-Sztainer D . Parenting style as a predictor of adolescent weight and weight-related behaviors. J Adolesc Health. 2010; 46(4):331-8. PMC: 2844861. DOI: 10.1016/j.jadohealth.2009.08.004. View

16.

Taveras E, Gillman M, Kleinman K, Rich-Edwards J, Rifas-Shiman S . Racial/ethnic differences in early-life risk factors for childhood obesity. Pediatrics. 2010; 125(4):686-95. PMC: 3836212. DOI: 10.1542/peds.2009-2100. View

17.

Ramsay S, Branen L, Fletcher J, Price E, Johnson S, Sigman-Grant M . "Are you done?" Child care providers' verbal communication at mealtimes that reinforce or hinder children's internal cues of hunger and satiation. J Nutr Educ Behav. 2010; 42(4):265-70. DOI: 10.1016/j.jneb.2009.07.002. View

18.

Hurley K, Cross M, Hughes S . A systematic review of responsive feeding and child obesity in high-income countries. J Nutr. 2011; 141(3):495-501. PMC: 3040906. DOI: 10.3945/jn.110.130047. View

19.

Huh S, Rifas-Shiman S, Taveras E, Oken E, Gillman M . Timing of solid food introduction and risk of obesity in preschool-aged children. Pediatrics. 2011; 127(3):e544-51. PMC: 3065143. DOI: 10.1542/peds.2010-0740. View

20.

Benjamin Neelon S, Briley M . Position of the American Dietetic Association: benchmarks for nutrition in child care. J Am Diet Assoc. 2011; 111(4):607-15. DOI: 10.1016/j.jada.2011.02.016. View