Published online October 1, 2008
PEDIATRICS Vol. 122 No. 4 October 2008, pp. e854-e860 (doi:10.1542/10.1542/peds.2008-0831)
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ARTICLE

Food Insecurity and Compensatory Feeding Practices Among Urban Black Families

Emily Feinberg, ScD, CPNPa,b, Patricia L. Kavanagh, MDb, Robin L. Young, MAc and Nicole Prudent, MD, MPHb,d

Departments of a Maternal and Child Health
c Biostatistics, Boston University School of Public Health, Boston, Massachusetts
b Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts
d Haitian Health Institute, Boston Medical Center, Boston, Massachusetts

OBJECTIVE. In this we study explored the relationship between food insecurity and compensatory maternal feeding practices that may be perceived as buffers against periodic food shortages among urban black families.

METHODS. We interviewed a convenience sample of black mothers of children aged 2 to 13 years. Food-security status (predictor) was determined at the household level. Five maternal feeding practices (outcomes) were assessed. Two were based on Birch's Child Feeding Questionnaire (restricting access to certain foods and pressuring a child to eat), and 3 were derived from investigators' clinical experience (use of high-energy supplements, added sugar in beverages, and perceived appetite stimulants). Anthropometric data were collected from mothers and children.

RESULTS. A total of 278 mother–child dyads were analyzed, and 28% of these mothers reported being food insecure. Use of Child Feeding Questionnaire feeding practices was defined as the top quartile of responses. Use of nutritional supplements, defined as "at least 1 to 2 times monthly," ranged from 13% to 25%. In logistic regression models adjusted for child age, weight status, and ethnicity and maternal weight status, mothers from food-insecure households were significantly more likely to use high-energy supplements and appetite stimulants. The odds of using the remaining compensatory feeding practices (adding sugars to beverages, pressuring a child to eat, and restricting access to certain foods) were elevated among food-insecure households but did not reach statistical significance.

CONCLUSIONS. Household food insecurity was independently associated with 2 of the 5 maternal compensatory feeding practices studied, and such practices may alter the feeding environment. Longitudinal research is necessary to determine how the relationship between food security and compensatory maternal feeding practices may affect child weight trajectories.

Key Words: food insecurity • feeding behavior • overweight children • African American • Haitian

Abbreviations: CFQ—Child Feeding Questionnaire • OR—odds ratio • CI—confidence interval

Accepted Jun 18, 2008.


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Food Insecurity Is Not Associated with Childhood Obesity as Assessed Using Multiple Measures of Obesity
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