Parent feeding strategies for infants and young children at developmental risk in the first 24 months and their relationship to feeding stage and outcomes.

Parents adopt strategies to support successful feeding. The purpose of this study was to describe parent feeding strategies for children at risk for feeding disorders in the first 24 months and examine their relationship with food stage and concurrent feeding outcomes. Data was longitudinally collected from 220 parents of 257 infants who required neonatal intensive care via online questionnaires at 1-, 2-, 4-, 6-, 8-, 10-, 12-, 18-, and 24-months post term age. Types of food the child was eating at each age were organized into stages by most complex food eaten in the past week: liquids, purees, soft or firm solids. Based on the child's food stage, parents rated the frequency of use of 95 strategies, categorized as Behavioral, Change Environment, Modify Food, Mealtime Schedule, and Physical Support. Frequency of endorsement of individual strategies were rank ordered at each food stage. Mealtime Schedule strategies were the most common category endorsed during all food stages. All categories steadily declined across the food stages with the exception of Behavioral strategies, which increased at firm solids. More symptoms of problematic eating and more negative impact of feeding on parent and family were associated with higher use of strategies. Low eating skills were associated with more Change Environment strategies at purees, more Change Environment, Modify Food, Mealtime Schedule, and PhysicalSupport strategies at soft solids and more Change Environment and Mealtime Schedule strategies at firm solids. Findings increase understanding of the feeding strategies parents adopt with children at risk for feeding difficulties and longitudinally associates their use with feeding outcomes across the first 2 years.