Goulding Alison N, Rosenblum Katherine L, Miller Alison L, Peterson Karen E, Chen Yu-Pu, Kaciroti Niko, Lumeng Julie C
Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, 10th Floor, 48109 Ann Arbor, MI, USA.
Int J Behav Nutr Phys Act. 2014 Jun 16;11:75. doi: 10.1186/1479-5868-11-75.
Maternal depression may influence feeding practices important in determining child eating behaviors and weight. However, the association between maternal depressive symptoms and feeding practices has been inconsistent, and most prior studies used self-report questionnaires alone to characterize feeding. The purpose of this study was to identify feeding practices associated with maternal depressive symptoms using multiple methodologies, and to test the hypothesis that maternal depressive symptoms are associated with less responsive feeding practices.
In this cross-sectional, observational study, participants (n = 295) included low-income mothers and their 4- to 8-year-old children. Maternal feeding practices were assessed via interviewer-administered questionnaires, semi-structured narrative interviews, and videotaped observations in home and laboratory settings. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies-Depression scale (CES-D). Regression analyses examined associations between elevated depressive symptoms (CES-D score ≥16) and measures of maternal feeding practices, adjusting for: child sex, food fussiness, number of older siblings; and maternal age, body mass index (BMI), education, race/ethnicity, single parent status, perceived child weight, and concern about child weight.
Thirty-one percent of mothers reported depressive symptoms above the screening cutoff. Mothers with elevated depressive symptoms reported more pressuring of children to eat (β = 0.29; 95% Confidence Interval (CI): 0.03, 0.54) and more overall demandingness (β = 0.16; 95% CI: 0.03, 0.29), and expressed lower authority in child feeding during semi-structured narrative interview (Odds Ratio (OR) for low authority: 2.82; 95% CI: 1.55, 5.12). In homes of mothers with elevated depressive symptoms, the television was more likely audible during meals (OR: 1.91; 95% CI: 1.05, 3.48) and mothers were less likely to eat with children (OR: 0.48; 95% CI: 0.27, 0.85). There were no associations between maternal depressive symptoms and encouragement or discouragement of food in laboratory eating interactions.
Mothers with elevated depressive symptoms demonstrated less responsive feeding practices than mothers with lower levels of depressive symptoms. These results suggest that screening for maternal depressive symptoms may be useful when counseling on healthy child feeding practices. Given inconsistencies across methodologies, future research should include multiple methods of characterizing feeding practices and direct comparisons of different methodologies.
母亲抑郁可能会影响喂养方式，而喂养方式对决定儿童饮食行为和体重至关重要。然而，母亲抑郁症状与喂养方式之间的关联并不一致，并且大多数先前的研究仅使用自我报告问卷来描述喂养情况。本研究的目的是使用多种方法确定与母亲抑郁症状相关的喂养方式，并检验母亲抑郁症状与反应性较低的喂养方式相关的假设。
在这项横断面观察性研究中，参与者（n = 295）包括低收入母亲及其4至8岁的孩子。通过访谈员 administered问卷、半结构化叙事访谈以及在家中和实验室环境中的录像观察来评估母亲的喂养方式。使用流行病学研究中心抑郁量表（CES-D）测量母亲的抑郁症状。回归分析检验了抑郁症状升高（CES-D评分≥16）与母亲喂养方式测量指标之间的关联，并对以下因素进行了调整：孩子性别、食物挑剔程度、哥哥姐姐的数量；以及母亲年龄、体重指数（BMI）、教育程度、种族/族裔、单亲状况、感知到的孩子体重以及对孩子体重的担忧。
31%的母亲报告抑郁症状高于筛查临界值。抑郁症状升高的母亲报告对孩子进食施加了更多压力（β = 0.29；95%置信区间（CI）：0.03，0.54）以及更多的总体要求（β = 0.16；95% CI：0.03，0.29），并且在半结构化叙事访谈中在儿童喂养方面表现出较低的权威性（低权威性的优势比（OR）：2.82；95% CI：1.55，5.12）。在抑郁症状升高的母亲家中，用餐期间电视更有可能被听到（OR：1.91；95% CI：1.05，3.48），并且母亲与孩子一起吃饭的可能性较小（OR：0.48；95% CI：0.27，0.85）。在实验室进食互动中，母亲抑郁症状与鼓励或不鼓励进食之间没有关联。
抑郁症状升高的母亲比抑郁症状较低的母亲表现出反应性较低的喂养方式。这些结果表明，在就健康的儿童喂养方式进行咨询时，筛查母亲的抑郁症状可能会有所帮助。鉴于不同方法之间存在不一致性，未来的研究应包括多种描述喂养方式的方法以及对不同方法的直接比较。
