title: Maternal Concern for Child Undereating.
abstract: To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices.
  
  
  
  This was a cross-sectional analysis of an observational study with 286 mother-child dyads (mean child age, 71 months). Maternal concern for undereating was assessed using a semistructured interview. Mothers completed questionnaires to assess picky eating, food neophobia, and feeding practices. Feeding practices were further assessed using videotaped mealtime observations. Logistic regression was used to assess the association of maternal and child characteristics with maternal concern for undereating. Regression was used to assess the association of maternal concern for undereating with feeding practices, controlling for covariates.
  
  
  
  Over a third of mothers (36.5%) expressed concern that their child does not eat enough. Correlates of concern for undereating included child body mass index z-score (BMIz; odds ratio [OR] = 0.58; 95% confidence interval [CI], 0.43-0.77) and picky eating (OR = 2.41; 95% CI, 1.26-4.59). Maternal concern for undereating was associated with greater reported pressure to eat (relative risk [RR] = 1.97; 95% CI, 1.55-2.50), greater observed bribery (OR = 2.63; 95% CI, 1.50-4.60), and higher observed pressure (OR = 1.90; 95% CI, 1.08-3.36) during mealtimes.
  
  
  
  Mothers of children who are picky eaters and have a lower BMIz are more likely to be concerned that their children do not eat enough, and maternal concern for undereating is associated with pressuring and bribing children to eat. Pediatricians might address maternal concern for undereating by advising feeding practices that do not involve pressure and bribery, particularly among healthy weight children.
authors.affiliation: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. Electronic address: calbrown@wakehealth.edu.
authors.forename: Callie L
authors.initials: CL
authors.lastname: Brown
authors.affiliation: Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Mich.
authors.forename: Megan H
authors.initials: MH
authors.lastname: Pesch
authors.affiliation: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Eliana M
authors.initials: EM
authors.lastname: Perrin
authors.affiliation: Appugliese Professional Advisors, North Easton, Mass.
authors.forename: Danielle P
authors.initials: DP
authors.lastname: Appugliese
authors.affiliation: Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Mich.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Miller
authors.affiliation: Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Mich.
authors.forename: Katherine
authors.initials: K
authors.lastname: Rosenblum
authors.affiliation: Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Mich; Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Mich.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Lumeng
mesh_terms: D015992:Body Mass Index; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers; D009765:Obesity; D016017:Odds Ratio; D050177:Overweight; D016487:Parenting; D011795:Surveys and Questionnaires; D013851:Thinness
keywords: body weight; child eating behaviors; children; feeding practices; pressure to eat