• Dr Emma Derbyshire

Why Food Shouldn’t Be Used to Soothe: New Evidence.


Eating practices established in childhood contribute to lifelong nutritional habits. Children develop the motor skills required to feed themselves and also develop preferences that affect their food choices. Parents and carers are responsible for instilling healthy food choices and dietary practices in their children, which will shape the child’s food preferences and eating behaviour.


It is known that greater weight gain in infancy is a risk factor for childhood obesity, and as parents have a strong impact on the eating behaviour of children, food parenting has become a key area of research as it is vital to understand factors that contribute to childhood obesity. It is believed that parents should avoid methods that lead to toddlers over-eating. These methods can include excessive portion size, frequent snacking between meals, forcing children to eat everything on their plate, force-feeding and feeding to soothe in particular to get a child off to sleep.


Research into how a child’s characteristics, eg, temperament, may affect a parent’s feeding decisions and the consequences of these decisions is increasing in recent years. Studying a child’s temperament and both eating and weight status is vitally important to discover any links to childhood obesity. Studies have suggested that children with high emotionality may be at risk for childhood obesity and recent studies have been undertaken to investigate temperament and subsequent feeding practices by parents and carers and how this relates to weight gain during infancy, a precursor of childhood obesity. Understanding is further required of how a child’s characteristics can interact with parent feeding practices and relate to infant weight outcomes.


The Dutch Food to Soothe Study and its Association with Childhood Body mass index (BMI)

A study in The Netherlands, published in 2019, examined whether the use of food to soothe in infancy was associated with body composition later in life, and also whether children’s eating behaviours are implicated by this association. 3960 children took part in this population-based birth cohort, where the children’s eating behaviour, including food responsiveness, emotional eating was measured at 6 months, 4 years and 10 years of age. BMI, fat mass, and fat-free mass were also measured at 6 years and 10 years of age. Results from this study have shown that the use of food to soothe when infants were 6 months old resulted in a higher BMI from 6 years of age. This result was independent of infant weight, maternal BMI and other confounders. Hence, in this most recent study, the use of food to comfort a distressed infant was regularly associated with obesogenic eating behaviours and an unhealthy body composition throughout middle and late childhood.


The US Infant Temperament and Parent’s Use of Food to Soothe Study

A study in the US, published in 2018, examined the interaction between an infant’s temperament and the parents use of food to soothe the infant in distress. This was then studied as a potential predictor of weight gain across the first 2 years of the child’s life. 160 parents took part in this study by filling out a questionnaire to assess their child’s temperament and also by completing a 3-day cry diary when the child was 6 months of age to assess when they used food in response to their crying child. Infant temperament was also assessed by a laboratory visit when the child was 6 months and their weight and length were measured at 6 months and 18 months of age. Scientists performed multiple regressions to test the moderating effect of using food to soothe on weight gain. The results of this study have identified significant interactions in using food to soothe in predicting weight gain during a child’s first 2 years of life. Parents who used food to soothe had children with a greater weight-for-length gain in one year in comparison to those parents who tended to use food to soothe less. The findings point to the role of temperament in weight gain during infancy, but only if their parents used food to soothe.


Conclusions

Feeding practices have been implicated in children becoming overweight, and the long-term effects of using food to comfort a distressed child may well contribute to childhood obesity. Further studies are required with precise, repeated assessments of infant feeding practices, which will lead to understanding the direction of effect. This is required in order for the establishment of evidence-based guidelines for parents and carers on the use of food to soothe in the early years of a child’s life.


References

Jansen PW et al. (2019) Using Food to Soothe in Infancy is Prospectively Associated with Childhood BMI in a Population-Based Cohort. J Nutr. Apr

Riley LK et al. (2018) Nutrition in Toddlers. Am Fam Physician. Aug 15;98(4):227-233.

Stifter CA et al. (2018) Infant temperament and parent use of food to soothe predict change in weight-for-length across infancy: early risk factors for childhood obesity. Int J Obes (Lond). Sep;42(9):1631-1638.

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