Responsive Feeding Practices Among Caregivers of Children Aged 6-35 Months in China: Descriptive Study Involving Survey and Video Observation Methods.

BACKGROUND

Responsive feeding is an integral component of nurturing care under the umbrella of early childhood development and has been recommended as an optimal feeding practice globally.

OBJECTIVE

This study was conducted to explore responsive and nonresponsive feeding practices among caregivers of children aged 6-35 months in China. Factors influencing responsive/nonresponsive feeding practices were further explored.

METHODS

This study used a combination of survey and video observation approaches and was conducted in Hebei Province from August to October 2020. A cross-sectional survey (n=409) was conducted to measure caregivers' responsive/nonresponsive feeding practices using a prevalidated scale (5-point Likert scale). The overall and individual dimension scores were calculated. Multiple linear regression was performed to explore the demographic factors associated with responsive/nonresponsive feeding practices. Video observation was conducted among 42 caregiver-child pairs to record the dining episodes of main meals for a day at participants' homes. Videos taken were coded, and the feeding practices were extracted. The occurrence of each feeding practice was calculated. The results from the 2 methods were confirmatory and complementary to each other.

RESULTS

Caregivers adopted responsive feeding more frequently than nonresponsive feeding, with a median overall responsive feeding score of 3.52 (IQR 3.36-3.76) in the survey and a higher occurrence in video observation (responsive vs nonresponsive feeding: 75.6%-97.6% vs 0%-46.3%). No significant differences in feeding practices were found across breakfast, lunch, and dinner (all P>.05). Nonparental caregivers (β=0.13, 95% CI 0.05-0.21) and those with a household monthly income of >5000 RMB (>US $721; β=0.07, 95% CI 0.01-0.14) had a higher score for overall responsive feeding, while unemployed caregivers (β=-0.07, 95% CI -0.13 to -0.01) had a lower score.

CONCLUSIONS

Caregivers appear to be more likely to use responsive feeding practices than nonresponsive feeding practices. Interventions to promote responsive feeding should target parental, unemployed, and low-income caregivers. The findings of this study might serve as a reference for the comprehensive assessment of responsive feeding practices.