title: Emotional and instrumental feeding practices of Dutch mothers regarding foods eaten between main meals.
abstract: BACKGROUND
  To assess how much of a public health problem emotional and instrumental feeding practices are, we explored the use of these feeding practices in a sample of Dutch mothers regarding their child's food intake between main meals.
  
  
  METHODS
  A cross-sectional questionnaire study was conducted among 359 mothers of primary school children aged 4-12 years. The questionnaires were completed online at home.
  
  
  RESULTS
  Of the mothers, 29.5% reported using foods to reward, 18.1% to punish and 18.9% to comfort their child. Mothers most frequently offered energy-dense and nutrient-poor products such as candy in the context of emotional and instrumental feeding practices. The use of these practices was associated with a lower age of both mother and child and a higher educational level of the mother. Mothers living in neighborhoods with intermediate socioeconomic position used the practices less often than mothers from low and high socioeconomic position neighborhoods.
  
  
  CONCLUSIONS
  Our results show that mothers in our sample mainly used unhealthy products in the context of instrumental and emotional feeding practices. Research into the association between these practices and children's dietary intake is warranted, since the use of unhealthy products in the context of these practices may not necessarily lead to an increased consumption of these products. Findings regarding the frequency of use of these practices among specific subgroups can be used to carefully determine the target population for interventions and tailor the content of interventions to specific target group characteristics. Besides examining associations between personal and family characteristics and the use of emotional and instrumental feeding practices, attempts should be made to understand parents' reasons for using them.
authors.affiliation: Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre +, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. lieke.raaijmakers@maastrichtuniversity.nl.
authors.forename: Lieke G M
authors.initials: LG
authors.lastname: Raaijmakers
authors.forename: Dorus W M
authors.initials: DW
authors.lastname: Gevers
authors.forename: Dorit
authors.initials: D
authors.lastname: Teuscher
authors.forename: Stef P J
authors.initials: SP
authors.lastname: Kremers
authors.forename: Patricia
authors.initials: P
authors.lastname: van Assema
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004435:Eating; D005191:Family Characteristics; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D009035:Mothers; D009426:Netherlands / Q000453:epidemiology; D063766:Pediatric Obesity / Q000517:prevention & control*; D011795:Surveys and Questionnaires