Prolonged Early Food Insecurity and Child Feeding Practices among a Low-Income Hispanic Population: Role of Parenting Stress

Acad Pediatr. 2024 Nov-Dec;24(8):1296-1303. doi: 10.1016/j.acap.2024.06.013. Epub 2024 Jun 28.

Abstract

Objective: To examine associations between prolonged early household food insecurity (FI) during pregnancy, infancy, and toddlerhood, and child feeding practices, and the mediating role of dysfunctional parent-child interactions.

Methods: We conducted secondary longitudinal analyses of data from the Starting Early Program (StEP) randomized controlled trial, which studied a primary care-based child obesity prevention program for low-income Hispanic families. Our independent variable was FI, using the USDA Food Security Module, during the third trimester of pregnancy and at child ages 10- and 19-months. Frequency of reported FI was defined by the number of periods with FI (0, 1, 2, or 3). Our dependent variables were feeding practices at child age 28-months using the Comprehensive Feeding Practices Questionnaire. Our mediating variable was dysfunctional parent-child interactions using the Parenting Stress Index subscale at age 19-months. We used linear regression to determine associations between frequency of reported FI and feeding practices adjusting for covariates, and mediation analyses to determine if dysfunctional parent-child interactions mediate these associations.

Results: Three hundred and forty four mothers completed assessments at child age 28-months. Of the 12 feeding practices examined, higher frequency of reported FI was positively associated with using food as a reward, restriction of food for weight control, and using food for emotional regulation, and was negatively associated with monitoring of less healthy foods. There was a significant indirect effect of frequency of reported FI on these practices through dysfunctional parent-child interactions.

Conclusion: Higher frequency of reported FI was associated with four feeding practices, through dysfunctional parent-child interactions. Understanding these pathways can inform preventive interventions.

Keywords: early childhood; feeding practices; food insecurity; parenting stress.

MeSH terms

  • Adult
  • Child, Preschool
  • Feeding Behavior* / psychology
  • Female
  • Food Insecurity*
  • Hispanic or Latino* / psychology
  • Humans
  • Infant
  • Linear Models
  • Longitudinal Studies
  • Male
  • Parent-Child Relations
  • Parenting* / psychology
  • Pediatric Obesity / ethnology
  • Pediatric Obesity / prevention & control
  • Pediatric Obesity / psychology
  • Poverty*
  • Pregnancy
  • Pregnancy Trimester, Third / psychology
  • Stress, Psychological* / ethnology