Mothers' feeding behaviors in infancy: Do they predict child weight trajectories?

Objective To determine associations between mothers' feeding behaviors in infancy and children's weight from infancy through to toddlerhood in urban, low-income, minority families and to explore the contribution of concerns about infant eating/weight. Methods One hundred sixty-nine mother-infant dyads (88% African-American) were recruited from an inner city pediatric practice. Questionnaires measuring restrictive feeding, pressuring to eat, and concerns about infant overeating/weight and undereating/weight were administered, and infants weighed and measured, at 6-12 months. Anthropometric data up to 30 months were obtained from multiple (8.9 ± 2.6) well-child visits, with 84% completing 11 visits. Results Higher pressuring was associated with lower weight-for-length z-scores (WLZ) over the period from baseline out to 30 months and higher restriction with higher child WLZ over the same period. Pressuring and concern about infant undereating/weight were independently associated with WLZ, but the relationship between restrictive feeding and WLZ was reduced by accounting for concern about infant overeating/weight. Child weight trajectories were not influenced by feeding behavior. Conclusions Mothers restricted heavier infants and pressured leaner infants to eat, and the relationship between restriction and higher infant weight was mediated by concern about infant overeating/weight. Correcting misperceptions and discussing feeding with mothers reporting concern may help prevent excessive early weight gain.