title: Maternal feeding practices and fussy eating in toddlerhood: a discordant twin analysis.
abstract: BACKGROUND
  Parental feeding practices are thought to play a causal role in shaping a child's fussiness; however, a child-responsive model suggests that feeding practices may develop in response to a child's emerging appetitive characteristics. We used a novel twin study design to test the hypothesis that mothers vary their feeding practices for twin children who differ in their 'food fussiness', in support of a child-responsive model.
  
  
  METHODS
  Participants were mothers and their 16 month old twin children (n = 2026) from Gemini, a British twin birth cohort of children born in 2007. Standardized psychometric measures of maternal 'pressure to eat', 'restriction' and 'instrumental feeding', as well as child 'food fussiness', were completed by mothers. Within-family analyses examined if twin-pair differences in 'food fussiness' were associated with differences in feeding practices using linear regression models. In a subset of twins (n = 247 pairs) who were the most discordant (highest quartile) on 'food fussiness' (difference score ≥ .50), Paired Samples T-test were used to explore the magnitude of differences in feeding practices between twins. Between-family analyses used Complex Samples General Linear Models to examine associations between feeding practices and 'food fussiness'.
  
  
  RESULTS
  Within-pair differences in 'food fussiness' were associated with differential 'pressure to eat' and 'instrumental feeding' (ps < .001), but not with 'restriction'. In the subset of twins most discordant on 'food fussiness', mothers used more pressure (p < .001) and food rewards (p < .05) with the fussier twin. Between-family analyses indicated that 'pressure to eat' and 'instrumental feeding' were positively associated with 'food fussiness', while 'restriction' was negatively associated with 'food fussiness' (ps < .001).
  
  
  CONCLUSIONS
  Mothers appear to subtly adjust their feeding practices according to their perceptions of their toddler's emerging fussy eating behavior. Specifically, the fussier toddler is pressured more than their less fussy co-twin, and is more likely to be offered food rewards. Guiding parents on how to respond to fussy eating may be an important aspect of promoting feeding practices that encourage food acceptance.
authors.affiliation: Centre for Children's Health Research, Queensland University of Technology, South Brisbane, 4101, Australia.|School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, 4059, Australia.|Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK.
authors.forename: Holly A
authors.initials: HA
authors.lastname: Harris
authors.affiliation: Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Fildes
authors.affiliation: School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, 4059, Australia.|School of Psychology, Australian Catholic University, Brisbane, 4014, Australia.
authors.forename: Kimberley M
authors.initials: KM
authors.lastname: Mallan
authors.affiliation: Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK. c.llewellyn@ucl.ac.uk.|University College of London, Gower Street, London, WC1E 6BT, UK. c.llewellyn@ucl.ac.uk.
authors.forename: Clare H
authors.initials: CH
authors.lastname: Llewellyn
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000523:psychology*; D008297:Male; D009035:Mothers / Q000523:psychology*; D011594:Psychometrics; D011795:Surveys and Questionnaires; D014427:Twins / Q000523:psychology* / Q000706:statistics & numerical data; D006113:United Kingdom
keywords: Children; Diet; Eating behaviour; Feeding practices; Food fussiness; Twin study