Responsive feeding, diabetes management, weight status and diet quality in a culturally diverse group of 1–5-year-old Australian children with type 1 diabetes

Aims

To examine responsive feeding in culturally-and-linguistically diverse (CALD) Australian children (1–5 years) with type-1 diabetes (T1D) and associations with diabetes management, weight status and diet quality.

Methods

A retrospective, cross-sectional multi-centre study assessed parental feeding practices, child feeding behaviours, mealtime structure and child’s dietary intake.

Results

76 families participated with CALD parents more likely to engage in Reward for Behaviour (p = 0.02), Persuasive Feeding (p = 0.04) and Overt Restriction (p = 0.01). Eating > 2 meals/day in front of TV/screen was associated with Reward for Eating (p = 0.004), Persuasive Feeding (p = 0.01) and CALD background (p = 0.001). Children with HbA1c < 7.0 % experienced more Covert Restriction (p = 0.002). Those on multiple daily injections were more likely to be Rewarded for Eating (p = 0.04) and experience Persuasive Feeding (p = 0.02) but more Willing to try new foods (p = 0.01) compared to children using insulin pump therapy. Only 9 % met Australian recommendations for vegetables and 67 % exceeded recommendations for discretionary foods.

Conclusions

Young children with T1D are not meeting healthy eating guidelines, with over half above a healthy weight. Exposure to non-responsive feeding practices is culturally sensitive and impacts diabetes management. A validated assessment tool identifies feeding and mealtime concerns, facilitating targeted conversations about not only what children eat, but also how they are fed.