Early childhood feeding: assessing knowledge, attitude, and practices of multi-ethnic child-care providers

Early childhood is a critical period for shaping and influencing feeding and lifestyle behaviors that have implications for future weight and health. With more women in the workforce, families have become reliant on child care. Thus, the child-feeding relationship has become a shared responsibility between the parent and child-care provider. Little is known about the impact of child-care providers on development of early childhood feeding behaviors and subsequent risk for obesity, especially in the Hispanic ethnic group. This research examined child-feeding attitudes, practices, and knowledge of multi-ethnic home-based and center-based child-care providers. Questionnaires were completed by a convenience sample of 72 providers, 50 of whom completed a pre- and post-test on child-feeding knowledge after receiving a 90-minute class based on Satter's division of responsibility feeding model during the spring of 2008. Results indicate many providers had practices consistent with this model. However, substantial differences were reported by Hispanic providers, who were statistically more likely to encourage children to finish meals before dessert, prepare foods they perceived as well-liked by children, coach children to eat foods perceived as appropriate, and not eat with children during meals. A substantial increase in knowledge from 73% correct at pretest to 82% at post-test was noted, with a substantial increase in knowledge on five of 13 questions. However, knowledge was not always congruent with behavior. This study points to differences among providers based on ethnicity, and strongly recommends recruiting Hispanic child-care providers to participate in educational programs and community efforts to prevent obesity.