Association between maternal nonresponsive feeding practice and child’s eating behavior and weight status: children aged 1 to 6 years


The purposes of this study are to investigate the prevalence of nonresponsive feeding practice (NRFP) and child’s eating behavior (CEB) and to explore the hypothetical association between child’s weight status, NRFP and CEB for 1- to 6-year-old children. In this study, 2423 caregivers of 1- to 6-year-old children are from the Nanjing Maternal and Child Health Hospital who completed the self-report questionnaires about their NRFP and CEB as well as their children’s sociodemographic data. Chi-square test and multiple regression analyses were used to examine the correlation between child’s weight status and NRFP and CEB. The total prevalence of overweight and obesity was 15.2 and 7.3%, respectively. High prevalence of CEB problems and NRFP was detected at 2- and 5-year-old children. Moreover, maternal NRFP was significantly positively associated with CEB. The regression and correlation analysis revealed CEB and maternal NRFP are closely associated with BMI. For instance, refusing new food (OR = 3.57, 95%CI, 1.37–9.33, 1.5-year-old) and restriction (OR = 3.01, 95%CI, 1.34–6.76) are likely to be associated with underweight. Preferring junk food (OR = 4.892, 95%CI, 1.71–14.01, 1-year-old) and inattention (OR = 2.24, 95%CI, 1.16–4.35, 1-year-old) are prone to be overweight and obese, and pressure (OR = 0.23, 95%CI, 0.06–0.91, 1-year-old) is less likely to be associated with underweight.

Conclusion: The findings provide strong evidence for the correlation between NRFR and CEB, and this indicates that prevention and intervention of unhealthy weight should start in early life. However, further research is necessary to gain an understanding of the impact of NRFP on CEB and weight.

What is known:
Responsive feeding practice is crucial to the formation of eating behavior, and poor practice is associated with the current epidemics of childhood obesity and underweight.
What is new:
The findings provide a strong evidence for the correlation between NRFR and CEB.
This finding indicates that NRFR and CEB are associated with child’s unhealthy weight.

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Fig. 1



Nonresponsive feeding practice


Child Eating Behavior Questionnaire


Responsive Feeding Questionnaire


Child’s eating behavior


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This work was supported by grants from the National Key Basic Research Program of China (2013CB530604), the National Natural Science Foundation of China (81500674, 81370964, 81330067), the Jiangsu Provincial Medical Youth Talent, Program for Innovative Research Teams of Jiangsu Province (LJ201108), the National Natural Science Foundation of Jiangsu Province (BK20150082) and the Project of Preeminent Youth Fund of Nanjing Public Health Bureau (JQX13013).

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All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Dr. Chunme Shi conceived and designed the experiments, conducted statistical analysis, wrote the paper, and contributed to the funding and suggestion.

Drs. Min Zhang and Xirong Guo conceived and designed the experiments, reviewed the manuscript, and contributed to the funding and suggestion.

Dr. Meiling Tong conceived and designed the experiments and reviewed the manuscript.

Drs. Nan Li and Xiling Li conducted the questionnaire survey and reviewed the manuscript.

RNs Li Wang and Jing Dong measured the weight and height of children and reviewed the manuscript.

Drs. Chenbo Ji and Xingyun Wang entered variables recorded on the questionnaire into a statistical package and reviewed the manuscript.

Corresponding authors

Correspondence to Xirong Guo or Meiling Tong or Min Zhang.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Hospital Administration (2014(55)).

Conflict of interest

All authors have no financial relationships with any organization relevant to this article to disclose. The authors declare that they have no conflict of interest.

Informed consent

All parents and their children gave their informed consent prior to their inclusion in the study.

Additional information

Communicated by Mario Bianchetti

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Shi, C., Li, N., Dong, J. et al. Association between maternal nonresponsive feeding practice and child’s eating behavior and weight status: children aged 1 to 6 years. Eur J Pediatr 176, 1603–1612 (2017).

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  • Nonresponsive feeding
  • Child’s eating behavior
  • Weight status
  • BMI