Active feeding behavior compensates for low interest in food among young Nicaraguan children

The association of caregivers' feeding behavior with young children's anthropometric status was examined in 80 poor urban families from Nicaragua. Caregiver and child behaviors observed during eating were recorded for midday meals, snacks and bottle feeds. Two kinds of scales were constructed. The Active Feeding Scale measured the caregiver's attempts to encourage or promote the child's food ingestion through behaviors such as verbal encouragement, threatening, offering more food or demonstrating eating. The Child Demand Scale measured the child's interest and enthusiasm for food. Results suggested the following: 1) there were significant differences in caregiver encouragement of feeding by meal type (midday meal, snack or bottle-feed); 2) mothers were significantly more likely to encourage eating than were other caregivers; and 3) active feeding was not associated with child anthropometric status but often appeared to be associated with child disinterest in the meal. It is suggested that active feeding may be used to compensate for child disinterest in food rather than to enhance the child's growth and developmental trajectory. The importance of lack of child interest in food, probably related to poor appetite, needs to be recognized and incorporated into nutrition education programs.