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Updated: Jun 27, 2025

A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Parent feeding practices in infants and toddlers referred to a hospital-based feeding program in the United States
Keith Williams1, Helen M Hendy2, Laura J Seiverling3
1Penn State Hershey Medical Center 905 West Governor Road, Hershey, PA, 17033, USA.
Insights
Parent feeding practices, like offering multiple foods, correlate with fewer feeding problems in infants and toddlers. However, some practices, such as using toys or TV during meals, may increase mealtime disruption.
Area of Science:
- Pediatric Nutrition
- Child Development
- Clinical Psychology
Background:
- Limited research exists on parent feeding practices for children with feeding problems.
- Feeding difficulties are common in infants and toddlers referred to specialized clinics.
Purpose of the Study:
- To identify parent feeding practices in infants and toddlers with feeding problems.
- To examine the correlation between identified parent feeding practices and specific feeding problems.
Main Methods:
- Parents of 399 infants and toddlers completed surveys on feeding practices and problems.
- Exploratory factor analysis developed the 16-item Baby Parent Mealtime Action Scale (BPMAS).
- Hierarchical regression analyzed associations between BPMAS dimensions and feeding problems.
Main Results:
- The Baby Parent Mealtime Action Scale (BPMAS) has three dimensions: Multiple Food Offers, Use of Cereal/Pureed Foods, and Use of Toys/TV.
- Offering multiple foods correlated with fewer instances of tube feeding, texture rejection, and limited diet variety.
- Using toys/TV during meals correlated with increased mealtime disruption.
Conclusions:
- Parent feeding practices are significantly correlated with feeding problems in young children.
- The 'Multiple Food Offers' dimension shows promise in mitigating several feeding issues.
- Understanding specific feeding practices can inform interventions for children with feeding difficulties.
Abstract:
While considerable research exists on parent feeding practices for infants and toddlers, past research has not focused on children with feeding problems. The goal of this study was to identify parent feeding practices in a sample of infants (n = 178) and toddlers (n = 221) referred to a hospital-based feeding clinic and then examine how these parent feeding practices were correlated with specific feeding problems. Parents completed surveys to report child demographics, feeding problems, and use of 54 feeding practices. Forty-eight (88.8%) of 54 practices were utilized more often for toddlers than for infants. Exploratory factor analysis with the 54 practices and the full sample (n = 399) produced the 16-item Baby Parent Mealtime Action Scale (BPMAS) with three dimensions: Multiple Food Offers, Use of Cereal/Pureed Foods, Use of Toys/TV. Controlling for demographics, hierarchical regression examined how each BPMAS dimension was associated with five feeding problems (underweight, tube feeding, texture problems, limited diet, mealtime disruption). Multiple Food Offers (e.g., daily offering of vegetables, offering foods from the family meal) was the dimension most correlated with fewer feeding problems such as tube feeding (β = -0.220, p < 0.001), texture rejection (β = -0.361, p < 0.001), and limited diet variety (β = -0.175, p < 0.001), but also with more mealtime disruption (β = 0.231, p < 0.001). Use of Toys/TV was correlated with more mealtime disruption (β = 0.260, p < 0.001). In addition to demonstrating a correlation between parent feeding practices and feeding problems, this study also found adding cereal/pureed foods to be common and while the dimension, Use of Cereal/Pureed Foods, was not significantly correlated with any specific feeding problem, this dimension provides an expanded understanding of cereal usage.
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