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The Relationship Between Feeding Styles and BMI Z-score in Infants (P11-014-19).

Objectives
The objective of this study was to determine the relationship between infant feeding styles (the attitudes and behaviors parents use to direct their child's eating) and infant BMI z-score in a low-income, predominately non-Hispanic Black population.


Methods
Parent-infant dyads were recruited during the infant's 6, 9, or 12 month well-child visits from two urban primary care clinics that primarily serve a Medicaid population (89%). Feeding styles were measured using the Infant Feeding Style Questionnaire (IFSQ) and categorized into: pressuring, restrictive, responsive, or laissez-faire. Predominant feeding style was defined by selecting the style with the greatest deviation from the mean score of each style. Infant anthropometrics were extracted from the electronic medical record from birth through 18 months. Infant BMI z-scores were calculated based on WHO growth charts. Associations between feeding styles and BMI z-scores were examined using mixed models controlling for multiple measures per person, demographics and feeding covariates.


Results
Data from 198 dyads were analyzed for this study (Table 1). Parents identified as mothers (n = 196), non-Hispanic Black (n = 136), with a median age of 27 years (IQR 23.0 - 30.0). Half the infants were male (n = 99) with a median age at enrollment of 8.98 months [IQR 6.8-10.3]. Parent's predominant feeding style were (in descending order): Laissez-faire: 30%; Restrictive: 28%; Responsive: 23%; and Pressuring: 19%. Predominant feeding style at enrollment was not associated with BMI z-score between 0-18 months, but there was a significant sex differences in BMI z-score for the Laissez-faire and Restrictive feeding styles (Figure 1). Additionally, parents with higher education and a predominately Restrictive feeding style had children with higher BMI z-scores whereas parents with higher education and a Laissez-faire or Pressuring feeding style had children with lower BMI z-score (Figure 2).


Conclusions
Parent's predominant feeding style during infancy in a low-income population is not associated with infant's BMI in the first two years of life, but some styles demonstrate differences by sex or parental education. Further studies are needed to better understand the modifiable factors for increased BMI in the first 2 years.


Funding Sources
NIH T32 Institutional grant.


Supporting Tables Images and/or Graphs