The incidence of childhood and adolescent overweight in the United States is increasing at an alarming rate and is now considered the most prevalent nutritional disease of children and adolescents in this country. Although much attention has focused on genetic research, and heredity is an unarguable component of obesity, the role of the environment must be considered because genetic changes over entire populations are not likely to occur at such a rapid rate. In observing today’s environment where energy-dense foods abound, restaurant dining has increased, and children are more sedentary than ever, the current trends in child/adolescent weight status are not surprising. This study digs to the heart of worrisome eating habits by exploring the development of these behaviors in the family. Previous studies show that parents’ use of child feeding practices is related to their children’s weight status. It is hypothesized that children of parents who utilize highly controlling feeding strategies (pressure, restriction, monitoring) will have nutrient intakes and weight indicators that are either higher or lower than the average for children whose parents exert less control over the eating domain. The objective of this research is to discover if significant relationships exist between parental child feeding strategies and child/adolescent overweight or underweight and nutrient intake. Birch’s model explaining familial resemblances in eating and weight status was tested using her previously validated Child Feeding Questionnaire, standard anthropometric techniques, three days of diet records, and a previously validated child questionnaire. Three-hundred and twelve children/adolescents, 254 mothers, and 245 fathers from the Houston Metropolitan Statistical Area completed interviews, and data was analyzed with the Statistical Analysis System (SAS). Results confirmed the validity of Birch’s model and previous studies that found significant relationships between child feeding strategies and children’s nutrition status. Parents who pressured their children to eat (motivated by concern about the child being underweight) were more likely to have children with lower BMI percentiles and skinfolds while parents who monitored or restricted the child’s intake had children with higher BMI percentiles and skinfold thicknesses. No clear relationships were found between feeding styles and nutrient intake.

The incidence of childhood and adolescent overweight in the United States is increasing at an alarming rate and is now considered the most prevalent nutritional disease of children and adolescents in this country. Although much attention has focused on genetic research, and heredity is an unarguable component of obesity, the role of the environment must be considered because genetic changes over entire populations are not likely to occur at such a rapid rate. In observing today’s environment where energy-dense foods abound, restaurant dining has increased, and children are more sedentary than ever, the current trends in child/adolescent weight status are not surprising. This study digs to the heart of worrisome eating habits by exploring the development of these behaviors in the family. Previous studies show that parents’ use of child feeding practices is related to their children’s weight status. It is hypothesized that children of parents who utilize highly controlling feeding strategies (pressure, restriction, monitoring) will have nutrient intakes and weight indicators that are either higher or lower than the average for children whose parents exert less control over the eating domain. The objective of this research is to discover if significant relationships exist between parental child feeding strategies and child/adolescent overweight or underweight and nutrient intake. Birch’s model explaining familial resemblances in eating and weight status was tested using her previously validated Child Feeding Questionnaire, standard anthropometric techniques, three days of diet records, and a previously validated child questionnaire. Three-hundred and twelve children/adolescents, 254 mothers, and 245 fathers from the Houston Metropolitan Statistical Area completed interviews, and data was analyzed with the Statistical Analysis System (SAS). Results confirmed the validity of Birch’s model and previous studies that found significant relationships between child feeding strategies and children’s nutrition status. Parents who pressured their children to eat (motivated by concern about the child being underweight) were more likely to have children with lower BMI percentiles and skinfolds while parents who monitored or restricted the child’s intake had children with higher BMI percentiles and skinfold thicknesses. No clear relationships were found between feeding styles and nutrient intake.

Context: Despite the many initiatives implemented over the past decades as part of the global priority on child survival, there still exists high infant mortality in Southern Africa. Although studies have examined factors contributing to poor child health outcomes including the effect of the HIV/AIDS pandemic, there is paucity of studies on the possible effect of infant feeding practices on infant mortality in the region. This study examines the association between infant feeding practices and infant mortality in Southern Africa. The need to reduce infant mortality is a global health concern hence the United Nations through the Millennium Development Goals (MDGs) declared the reduction of infant and child mortality as one of its major targets by the year 2015. Methods: A merged dataset from the most recent Demographic and Health Surveys for Lesotho, Swaziland, Zambia and Zimbabwe was analysed in this study. A total number of 13, 218 infants born in the last five years preceding the surveys whose information on infant feeding practices was available formed the analysis sample. The outcome variable was infant mortality and infant feeding practices which had the categories, no breastfeeding, partial breastfeeding and exclusive breastfeeding was the main explanatory variable of the study. Other explanatory variables used in the study pertained to maternal demographic and socioeconomic characteristics as well as the infants’ bio-demographic characteristics. The Cox Hazard Regression Model was employed to examine both the unadjusted and adjusted effect of infant feeding practices on infant mortality in Southern Africa. Results: Although, exclusive breastfeeding was quite low (12%), its mortality reduction effect was significant, and infants who were exclusively breastfed exhibited a 97% lower risk of dying during infancy compared to no breastfeeding in the region. Further, variations exist by country in the levels and patterns of both infant mortality and infant feeding practices. Country, highest educational level, marital status, sex of child, preceding birth interval and birth weight were the significant predictors of infant mortality in Southern Africa. Conclusions: Overall, the study found that any form of breastfeeding whether exclusive or partial breastfeeding greatly reduces the risk of infant mortality, with the mortality reduction effect being higher among exclusively breastfed infants in the Southern African region. Thus, in order to reduce the upsurge of infant mortality, there is need to step up the effectiveness of child nutrition programmes that promote breastfeeding and put emphasis on exclusive breastfeeding of infants in the region.

Childhood obesity has been increased dramatically and become a public health concern in China. Parents have strong influence on children's eating and weight status. However, there is a lack of data about the influence of Chinese parents' child-feeding practices on children's weight status. This study aimed to assess parents' child-feeding practices and examine their relationships to young Chinese adolescents' weight status. A self-administrated survey was conducted among parents of young Chinese adolescents in Beijing urban areas. The survey included 29 items from Birch's Child-feeding Questionnaire (CFQ) and 15 items developed by the researcher to assess parents' attitudes, behaviors and family food environment regarding child feeding. Parents were recruited through students in public middle schools in two Beijing urban areas. Children's annual check-up data (weight and height) was obtained from schools. 598 parents of students in 7th and 8th grades were surveyed and 548 of them responded to the survey. By excluding those who were not primarily responsible for preparing family meals and those whose children's check-up data was missing, final data analysis included 355 records. The prevalence of overweight and obesity among children were 19.4% and 9.0%, respectively, using International Obesity Task Force recommendations. Boys had significant higher prevalence of obesity than girls. Results show that parents of young Chinese adolescents used controlling feeding practices to regulate the child's eating, including restriction of certain food, pressure to eat and monitoring of the child's eating. Parents indicated that they had some concerns about their child's being overweight. The family food environment was generally positive in these families with some unhealthy elements in sizeable proportion of families. After adjusting for socioeconomic factors and parents' BMI, multiple regression analysis showed there were positive associations of restriction and family eating patterns, and an inverse association of pressure to eat to children's BMI z-scores. Parents' child-feeding practices may have significant influence on children's weight status. Family-based intervention is needed to help establish or maintain a healthy eating environment at home in order to combat the rising obesity prevalence in Chinese youths. Further studies also are needed to gain better understanding of parental influence on children's weight status.

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In this mini-dissertation the aim was to explore and describe the safety of infant feeding practices. It is argued that safe infant feeding practices can have a positive and long term effect on the health status and growth development of all infants. World wide, countries but more specific developing countries, are faced with the growing dilemma of high mortality and morbidity rates among infants. The need to find a way to eliminate and prevent the causing factors of life-threatening infectious diseases like diarrhoea and HIV/AIDS is now more important than ever before. A sound nutritional foundation together with safe infant feeding methods play a predominant role in ensuring the very survival of the infant. A cross-sectional, descriptive research design was used in this study. Non-probability sampling was used to identify the sample who complied with the set selection criteria. The research took place in a semi-urban community as the community serves a large group of mothers and infants as well as being accessible to the researcher. The semi-urban community was also identified as an area with health care needs that could be addressed in the research project. A questionnaire was adapted from an existing WHO assessment tool. A pilot study was conducted after which the questionnaire was finalised and the questionnaires were completed with the aid of three fieldworkers. Data collection took place until the sample size (n=155) was achieved according to the calculation of the statistician. The data analysis was done by means of descriptive statistics such as frequency, percentage, mean and standard deviation by using the STATISTICA data analysis software system programme. The results of the research study indicated that the majority of participants practice mixed feeding methods which do not comply with safe infant feeding standards. Infant feeding methods are not changed during illness or disease experienced by either the mother or infant, which again may greatly compromise their health status. The uptake of HIV testing and disclosure were relatively high. Recommendations are made for nursing education, nursing research and nursing practice with special focus on establishing safe infant feeding practices. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2008.

In this mini-dissertation the aim was to explore and describe the safety of infant feeding practices. It is argued that safe infant feeding practices can have a positive and long term effect on the health status and growth development of all infants. World wide, countries but more specific developing countries, are faced with the growing dilemma of high mortality and morbidity rates among infants. The need to find a way to eliminate and prevent the causing factors of life-threatening infectious diseases like diarrhoea and HIV/AIDS is now more important than ever before. A sound nutritional foundation together with safe infant feeding methods play a predominant role in ensuring the very survival of the infant. A cross-sectional, descriptive research design was used in this study. Non-probability sampling was used to identify the sample who complied with the set selection criteria. The research took place in a semi-urban community as the community serves a large group of mothers and infants as well as being accessible to the researcher. The semi-urban community was also identified as an area with health care needs that could be addressed in the research project. A questionnaire was adapted from an existing WHO assessment tool. A pilot study was conducted after which the questionnaire was finalised and the questionnaires were completed with the aid of three fieldworkers. Data collection took place until the sample size (n=155) was achieved according to the calculation of the statistician. The data analysis was done by means of descriptive statistics such as frequency, percentage, mean and standard deviation by using the STATISTICA data analysis software system programme. The results of the research study indicated that the majority of participants practice mixed feeding methods which do not comply with safe infant feeding standards. Infant feeding methods are not changed during illness or disease experienced by either the mother or infant, which again may greatly compromise their health status. The uptake of HIV testing and disclosure were relatively high. Recommendations are made for nursing education, nursing research and nursing practice with special focus on establishing safe infant feeding practices. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2008.

Background: Breastfeeding is widely recognised as the ideal approach for improving child survival and feeding new-born babies and young infants. The World Health Organisation (WHO) recommends exclusive breastfeeding (EBF) for the first 6 months of life with timely introduction of complementary foods at 6 months and continued breastfeeding for up to two years and beyond. The feeding practices of mothers are widely influenced by different factors which may be embedded within different contexts of life. Aim: This study explored the infant feeding practices of mothers and/or caregivers of infants below the age of 6 months. Method: This cross sectional study was conducted in four provinces in South Africa. In total, 40 health facilities were randomly selected in the four provinces and visited including metropolitan and non-metropolitan health facilities over the geographical area of the provinces. Fixed structured interviews were conducted and data on the feeding practices of mothers were collected using a questionnaire which had both open and closed-ended questions. Qualitative data were coded under different themes. The sample size comprised of mothers and/or caregivers of babies aged 6 months and below. A 24-hour recall was completed for all infants. Dietary intake and diversity were assessed using the FAO dietary diversity list consisting of 12 different food groups. Descriptive statistics, crosstabs and Pearson chi-square tests were used. Results: A total of 580 mothers/caregivers of infants below the age of 6 months were interviewed. Ninety-five % (n=551) were biological mothers. A total of 490 (85%) were breastfeeding at the time of the interviews. Ninety % had initiated breastfeeding during the first hour after delivery. At the time of the study, 12% (n=4) of the women were practising exclusive breastfeeding (EBF) for the recommended 6 months. Sixteen % (n=90) were not breastfeeding at the time the interviews were conducted. More than two thirds (64%) had exclusively breastfed their infants but stopped at the time of the interviews and 36% (n=32) did not breastfeed their babies at all. Twelve % (n=4) of the mothers stopped breastfeeding from as early as one month. The most cited reasons by the participants for breastfeeding cessation were the need to return to work or school. Reasons for not breastfeeding at all included the mothers HIV status, poor health and insufficient milk production. Forty-one % (n=239) of the mothers believed that breastfeeding contains adequate nutrients for the child and 5.7% (33) did not know why breastfeeding is important. Nearly half (49%) were giving infant feeding formula. Seventy % (n=220) of the women were giving either infant feeding formula or other liquids in addition to breast milk. The most stated reason for giving other liquids or foods was the belief that breast milk was not enough for the infant. Almost two thirds (56%) of the mothers gave their infants fortified infant feeding formula. Only one infant (0.2%) met the minimum standard of dietary diversity. Complementary food was introduced from as early as one month, and 73% of the women reported that their infants were receiving dietary supplements. Conclusion: Breastfeeding still remains a universal practice in the country. Sustained exclusive breastfeeding is still a cause of concern and 6 month EBF rates remain very low. Both mothers and caregivers had sound understanding of the importance of breastfeeding. Early initiation of complementary foods is still a norm and wide problem in the country. The dietary diversity of complementary diets given to babies was nutritionally inadequate. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015

Background: Breastfeeding is widely recognised as the ideal approach for improving child survival and feeding new-born babies and young infants. The World Health Organisation (WHO) recommends exclusive breastfeeding (EBF) for the first 6 months of life with timely introduction of complementary foods at 6 months and continued breastfeeding for up to two years and beyond. The feeding practices of mothers are widely influenced by different factors which may be embedded within different contexts of life. Aim: This study explored the infant feeding practices of mothers and/or caregivers of infants below the age of 6 months. Method: This cross sectional study was conducted in four provinces in South Africa. In total, 40 health facilities were randomly selected in the four provinces and visited including metropolitan and non-metropolitan health facilities over the geographical area of the provinces. Fixed structured interviews were conducted and data on the feeding practices of mothers were collected using a questionnaire which had both open and closed-ended questions. Qualitative data were coded under different themes. The sample size comprised of mothers and/or caregivers of babies aged 6 months and below. A 24-hour recall was completed for all infants. Dietary intake and diversity were assessed using the FAO dietary diversity list consisting of 12 different food groups. Descriptive statistics, crosstabs and Pearson chi-square tests were used. Results: A total of 580 mothers/caregivers of infants below the age of 6 months were interviewed. Ninety-five % (n=551) were biological mothers. A total of 490 (85%) were breastfeeding at the time of the interviews. Ninety % had initiated breastfeeding during the first hour after delivery. At the time of the study, 12% (n=4) of the women were practising exclusive breastfeeding (EBF) for the recommended 6 months. Sixteen % (n=90) were not breastfeeding at the time the interviews were conducted. More than two thirds (64%) had exclusively breastfed their infants but stopped at the time of the interviews and 36% (n=32) did not breastfeed their babies at all. Twelve % (n=4) of the mothers stopped breastfeeding from as early as one month. The most cited reasons by the participants for breastfeeding cessation were the need to return to work or school. Reasons for not breastfeeding at all included the mothers HIV status, poor health and insufficient milk production. Forty-one % (n=239) of the mothers believed that breastfeeding contains adequate nutrients for the child and 5.7% (33) did not know why breastfeeding is important. Nearly half (49%) were giving infant feeding formula. Seventy % (n=220) of the women were giving either infant feeding formula or other liquids in addition to breast milk. The most stated reason for giving other liquids or foods was the belief that breast milk was not enough for the infant. Almost two thirds (56%) of the mothers gave their infants fortified infant feeding formula. Only one infant (0.2%) met the minimum standard of dietary diversity. Complementary food was introduced from as early as one month, and 73% of the women reported that their infants were receiving dietary supplements. Conclusion: Breastfeeding still remains a universal practice in the country. Sustained exclusive breastfeeding is still a cause of concern and 6 month EBF rates remain very low. Both mothers and caregivers had sound understanding of the importance of breastfeeding. Early initiation of complementary foods is still a norm and wide problem in the country. The dietary diversity of complementary diets given to babies was nutritionally inadequate. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015

The present study evaluated associations between parent-child connectedness and communication, parent perceptions of child weight, parent feeding behaviors (restriction, pressure to eat, and monitoring), and child body mass index percentile among a sample of children aged 8-12 years. To evaluate these associations, this study used a cross-sectional design and maximum likelihood (ML) structural equation modeling to examine a mediation model with parental feeding behaviors mediating the associations between parent-child relationship quality and child body mass index. Furthermore, because of the known associations between parental perceptions of child weight and parent feeding practices, models examining the mediating effects of parent feeding practices between parent perceptions of child weight and child body mass index were also examined. Finally, we used mixture modeling to conduct latent profile analyses, specifying high, moderate, and low levels of each feeding behavior, in order to examine the mediation effects of specific levels of feeding behaviors. Study findings supported restriction as a mediator between parent reported communication (PRC) and child weight, as well as between parent perceptions of child weight (PCW) and child weight. The results also indicated that parent perceptions of child weight predicted feeding practices and child weight. Both restriction and monitoring predicted child weight. Overall, these findings provide evidence for the role of parent-child relationship quality in predicting parent feeding behavior. However, study findings suggest that these associations may differ depending on the rater (i.e., child, parent).