Child Attachment Behavior As a Moderator of the Relation Between Feeding Responsiveness and Picky Eating Behavior

Background: Picky eating (PE) behavior is common in early childhood, but persistent PE is associated with unhealthy development and caregiver-child stress during feeding. Identifying modifiable feeding and parent-child relationship factors that impact PE is important for decreasing risks associated with PE.

Objective: This study examined associations between caregiver Feeding Responsiveness (FR) and child PE behaviors using caregiver reports and observations of family mealtimes. An additional aim examined whether children's attachment behavior moderates this association.

Methods: The analysis sample consisted of 110 families participating in a larger longitudinal study of nutrition and child health. Home observations were conducted when children were 18-24 months (52% females) to assess caregiver-child interactions. Caregivers were, on average, 30.9 years old and mostly White (73.6%). Family mealtimes were videotaped and coded for FR and child PE behaviors. Caregivers completed surveys regarding FR and PE behaviors.

Results: Caregiver-reported FR was significantly correlated with observed FR, r (107) = 0.26, p = 0.007; and caregiver-reported PE was associated with observed PE, r (107) = 0.21, p = 0.029. Caregiver-reported FR was inversely related to observed PE, but only when children were characterized by observers to have more positively toned and smooth interactions with caregivers. Using observational data, child attachment significantly moderated the relationship between FR and PE behaviors.

Conclusions: The quality of caregiver-child interactions may impact the degree to which FR is effective in reducing PE. Future longitudinal studies that include more diverse populations, multiple caregivers, and potential mechanisms accounting for these associations are needed.