Background

Heritability studies suggest that emotional overeating (EOE) in early childhood is learned in the family home environment. However, determinants of EOE are yet to be identified. Parents’ use of food to soothe (FTS) child distress is hypothesized to drive or reinforce children’s EOE. This secondary data analysis examines the effect of a responsive parenting (RP) intervention on child EOE, and whether this association is mediated by mothers’ FTS.

Methods

Participants were primiparous mothers and their infants from the INSIGHT RCT, who were recruited during the birth hospitalization and randomized to a RP intervention or safety control. Nurses delivered RP content and guided mothers to respond appropriately to infant appetite cues and taught alternatives to using FTS. Mothers with complete data (n=207) on the validated ‘Babies Need Soothing’ (BNS) FTS scale at child age 18-months and the ‘Children’s Eating Behavior Questionnaire’ EOE scale at age 2.5 years were included in the analyses (anchored on 5-point Likert scales). Independent samples t-tests examined differences in FTS and EOE by study group. Mediation analysis was performed using the SPSS PROCESS macro. Sub-analyses further examine the mediating effect of mothers’ FTS in specific situations using the ‘context-based’ and ‘emotional-based’ BNS subscales.

Results

Mothers were 29.5 years old at delivery, mostly white (95%) and highly educated (72% college educated). Mothers’ FTS at child age 18-months was moderately associated with child EOE at 2.5 years (r=.38, p<.001). Compared with controls, RP mothers reported lower FTS (1.9 vs 1.6, p=.004) and child EOE (1.3 vs 1.5, p=.02). FTS fully mediated the intervention effect on child EOE (B[SE]=-.07[.03]; 95% CI: -.12 to -.02).

Conclusions

Children’s EOE can be modified through an early life RP intervention. Findings from this research suggest that teaching parents alternative techniques to calm a distressed child rather than using FTS may curb EOE development and reduce future obesity risk.