Association of eating behaviors and parental feeding attitudes with weight-for-height Z score in children aged 0–2 years

Abstract

The aim of this study was to develop a questionnaire suitable for the 0–2 years old children with feeding problems in pediatric outpatient clinics and to investigate the association of eating behaviors and parental feeding attitudes with weight-for-height Z score (WHZ). We developed the questionnaire of Children's eating behaviors and Parental feeding attitudes (CEB-PFA), including 7 subscales with Eating behaviors, Picky eating, Food texture, Parental psychology, Feeding behaviors, Feeding knowledge, and Family factors, which was completed by parents of children aged 0–2 years in pediatric clinics. We conducted a reliability analysis of the CEB-PFA and examined gender and age differences in eating behaviors and parental feeding attitudes. Regression models assessed the association of eating behaviors, parental feeding attitudes, and weight-for-height Z scores of children aged 0–2 years, by controlling for month of age, sex, height-for-age Z scores (HAZ), small for gestational age infant (SGA), premature, Cow's milk protein allergy (CMPA), the child's Primary feeder, and the questionnaire filler. The subscales demonstrated satisfactory internal reliability (Cronbach's alpha ranging from 0.539 to 0.808). Significant age differences were observed in the Parental Feeding Behaviors subscale, and a correlation was found between WHZ and both parental psychology and feeding behaviors. This study confirmed that parental psychology and feeding behaviors were significantly associated with weight-for-height Z scores in infants and young children and provide child healthcare professionals with a potential tool to identify the primary causes of feeding difficulties in infants and young children.