Cited by 131Food Security and Health in Diverse PopulationsObesity, Physical Activity, DietChild Nutrition and Feeding Issues

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Food Insecurity and Obesogenic Maternal Infant Feeding Styles and Practices in Low-Income Families

Gross, Rachel S., Mendelsohn, Alan L., Fierman, Arthur H., Racine, Andrew D., Messito, Mary Jo·2012·Pediatrics

DOI 10.1542/peds.2011-3588

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Abstract

OBJECTIVES: We explored the relationship between household food insecurity and maternal feeding styles, infant feeding practices, and perceptions and attitudes about infant weight in low-income mothers. METHODS: Mothers participating in the Special Supplemental Food Program for Women, Infants, and Children with infants aged between 2 weeks and 6 months were interviewed. By using regression analyses, the following relationships were examined between food insecurity and: (1) controlling feeding styles (restrictive and pressuring); (2) infant feeding practices, including breastfeeding, juice consumption, and adding cereal to the bottle; and (3) perceptions and attitudes about infant weight. Path analysis was used to determine if perceptions and attitudes about infant weight mediated the relationships between food insecurity and controlling feeding styles. RESULTS: The sample included 201 mother–infant pairs, with 35% reporting household food insecurity. Food-insecure mothers were more likely to exhibit restrictive (B [SE]: 0.18 [0.08]; 95% confidence interval [CI]: 0.02–0.34) and pressuring (B [SE]: 0.11 [0.06]; 95% CI: 0.001–0.22) feeding styles compared with food-secure mothers. No associations were found with feeding practices. Concern for their infant becoming overweight in the future was associated with food insecurity (adjusted odds ratio: 2.11 [95% CI: 1.02–4.38]). This concern mediated the relationship between food insecurity and both restrictive (P = .009) and pressuring (P = .01) feeding styles. CONCLUSIONS: Increased concern about future overweight and controlling feeding styles represent potential mechanisms by which food insecurity could be related to obesity. Obesity prevention should aim to decrease food insecurity and to reduce controlling feeding styles in families who remain food insecure.

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Complex intertwined association between breastfeeding practices and household food insecurity: Systematic review and meta‐analysis
Buccini, G., Larrison, C., Neupane, S., Palapa, M., Schincaglia, R. M., Brown, S., & Gubert, M. B. (2024) · Maternal and Child Nutrition · doi:10.1111/mcn.13696 · Cited by 13
Maternal Stress and Infant Feeding in Hispanic Families Experiencing Poverty
Gross, R. S., Brown, N. M., Mendelsohn, A. L., Katzow, M. W., Arana, M. M., & Messito, M. J. (2021) · Academic Pediatrics · doi:10.1016/j.acap.2021.04.022 · Cited by 13
Self-citation
Infant appetite and weight gain in early infancy: Moderating effects of controlling feeding styles
Shriver, L. H., Eagleton, S. G., Lawless, M., Buehler, C. A., Wideman, L., & Leerkes, E. M. (2022) · Appetite · doi:10.1016/j.appet.2022.106139 · Cited by 12
A Mixed-Methods Analysis of a Special Supplemental Nutrition Program for Women, Infants, and Children and Primary Care Partnership to Promote Responsive Feeding for Infants in Group Well-Child Care
Budge, M., Sharifi, M., Maciejewski, K. R., Diehl, D., Paige, M., Nogelo, P., Rosenthal, M. S., & Fenick, A. M. (2023) · Academic Pediatrics · doi:10.1016/j.acap.2022.12.017 · Cited by 12
Measurement equivalence of child feeding and eating measures across gender, ethnicity, and household food security
Pérez, M., Ohrt, T. K., Bruening, A. B., Taylor, A. B., Liew, J., Diest, A. M. K. V., & Ungredda, T. (2018) · BMC Obesity · doi:10.1186/s40608-018-0192-6 · Cited by 12
“Despite these issues, the CFQ has been used to make group comparisons across a number of different groups, such as parents with boys versus girls [15], Latino versus European Americans [11, 16], food secure and food insecure households [5, 17] and among lowincome families without an assessment of food security [18, 19…”
Method
Applying the Family Stress Model to responsive feeding and early obesity prevention
Ruggiero, C. F., Trexberg, K. M., Moore, A. M., & Savage, J. S. (2024) · Appetite · doi:10.1016/j.appet.2024.107515 · Cited by 14
Associations between food provision and feeding practices in socially disadvantaged childcare centres
Searle, B., Staton, S., Littlewood, R., & Thorpe, K. J. (2021) · Appetite · doi:10.1016/j.appet.2021.105811 · Cited by 11
Brazilian immigrant fathers’ perspectives on child’s eating and feeding practices: a qualitative study conducted in the United States
Lindsay, A. C., Vianna, G. V. D. B., Arruda, C. A. M., Alves, A. D. S. M., Hasselmann, M. H., Machado, M. M. T., & Greaney, M. L. (2020) · Public Health Nutrition · doi:10.1017/s1368980020001123 · Cited by 11
“parental feeding beliefs and practices(61,62).”
Is the Prospective Link between Parental Stress and Adolescent Snack Intake or Weight Outcome Mediated by Food Parenting Practices?
Koning, M., Vink, J. M., Renders, C. M., Notten, N., Eisinga, R., & Larsen, J. K. (2021) · Nutrients · doi:10.3390/nu13082485 · Cited by 10
The impact of deprivation and neighbourhood food environments on home food environments, parental feeding practices, child eating behaviours, food preferences and BMI: The Family Food Experience Study-London
Smith, A. D., Kininmonth, A. R., Tommerup, K., Boniface, D. R., Gericke, C., Denning, T., Summerbell, C. D., Vogel, C., & Llewellyn, C. H. (2025) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-025-01788-7 · Cited by 9
“Previous research has also that parents from more disadvantaged backgrounds report using food as a reward or comforter for their child more frequently than do parents from more advantaged backgrounds [45–47].”
Early Childhood Food Insecurity and Cardiovascular Health in Young Adulthood
Lam, E., Gauen, A., Kandula, N. R., Notterman, D. A., Goldman, N., Lloyd‐Jones, D. M., Allen, N. B., & Shah, N. S. (2025) · JAMA Cardiology · doi:10.1001/jamacardio.2025.1062 · Cited by 9
Ecological factors and childhood eating behaviours at 5 years of age: findings from the ROLO longitudinal birth cohort study
Delahunt, A., Conway, M. C., O’Brien, E. C., Geraghty, A. A., O’Keeffe, L. M., O'Reilly, S. L., McDonnell, C. M., Kearney, P. M., Mehegan, J., & McAuliffe, F. M. (2022) · BMC Pediatrics · doi:10.1186/s12887-022-03423-x · Cited by 8
Household food security and breast-feeding duration among Canadian Inuit
McIsaac, K. E., Stock, D., & Lou, W. Y. W. (2016) · Public Health Nutrition · doi:10.1017/s136898001600166x · Cited by 8
Difficulty buying food, BMI, and eating habits in young children
Fuller, A. E., Maguire, J. L., Carsley, S., Chen, Y., Lebovic, G., Omand, J. A., Parkin, P. C., & Birken, C. S. (2017) · Canadian Journal of Public Health · doi:10.17269/cjph.108.6049 · Cited by 8
“You just have to spread it thin”: Perceptions and feeding experiences of Australian fathers of young children living with disadvantage
So, T. H. J., Byrne, R., Nambiar, S., Gallegos, D., & Baxter, K. A. (2024) · Appetite · doi:10.1016/j.appet.2023.107197 · Cited by 7
“This is consistent with maternal-focused research where low-income and food insecure families minimised purchasing disliked foods, exhibited more restrictive behaviours and experienced more family meal challenges (Daniel, 2016; Gross et al., 2012; Harris et al., 2019; Trofholz et al., 2021).”
Result
Socioeconomic Position and Picky Eating Behavior Predict Disparate Weight Trajectories in Infancy
Galloway, A. T., Watson, P., Pitama, S. G., & Farrow, C. V. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00528 · Cited by 7
Longitudinal Associations Among Food Insecurity During Pregnancy, Parental Mental Health Symptoms, Controlling Feeding Styles, and Infant Food Responsiveness
Eagleton, S. G., Shriver, L. H., Buehler, C. A., Wideman, L., & Leerkes, E. M. (2022) · Journal of Nutrition · doi:10.1093/jn/nxac225 · Cited by 6
Prenatal and Pediatric Primary Care-Based Child Obesity Prevention: Effects of Adverse Social Determinants of Health on Intervention Attendance and Impact
Duh‐Leong, C., Messito, M. J., Katzow, M. W., Kim, C. N., Mendelsohn, A. L., Scott, M. A., & Gross, R. S. (2024) · Childhood Obesity · doi:10.1089/chi.2023.0149 · Cited by 6
“4,5,20 We grouped adverse SDoHs in two domains likely to affect health through different pathways 7,21 : psychosocial stressors that intensify emotional stress (low social support, single marital status, and maternal depressive symptoms) and material hardships when families are unable to meet basic…”
Self-citation
Early Childhood Obesity: A Developmental Perspective
Pesch, M. H., & Lumeng, J. C. (2021) · Annual Review of Developmental Psychology · doi:10.1146/annurev-devpsych-050620-124758 · Cited by 7
Institute of Medicine Early Infant Feeding Recommendations for Childhood Obesity Prevention: Implementation by Immigrant Mothers From Central America
Gaffney, K. F., Brito, A. V., Kitsantas, P., Kermer, D. A., Pereddo, G., & Ramos, K. M. (2018) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2018.02.017 · Cited by 6
“By contrast, Gross et al. (2012) found that mothers reporting food insecurity were more likely to affirm controlling infant feeding styles than mothers who were food secure.”
Predictors of Food Insecurity in Lewiston, Maine: A Community-Level Analysis
Harris, D. E., Aboueissa, A., Walter, K., & Bampton, M. (2014) · Journal of Hunger & Environmental Nutrition · doi:10.1080/19320248.2013.840549 · Cited by 7
“One study of mother–infant pairs found that food insecure mothers were more likely to engage in feeding behaviors (restrictive and pressuring behaviors) that might be related to future obesity.(45) This study did not measure obesity.”
Background
Early Life Factors for Overweight Risk Among Infants of Hispanic Immigrant Mothers
Gaffney, K. F., Kermer, D. A., Kitsantas, P., Brito, A. V., Ramos, K. M., Pereddo, G., & Villatoro, L. G. (2018) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2018.05.011 · Cited by 6
Off the Charts: Identifying and Visualizing Body Mass Index Trajectories of Rural, Poor Youth
Rollins, B. Y., & Francis, L. A. (2020) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2020.09.007 · Cited by 5
“Low breastfeeding rates and early introduction of solids have been associated with lower socioeconomic status (46), and Gibbs et al suggest that infant feeding practices may partially explain the link between SES and obesity.”
Background
Duration of US Residence And Resource Needs In Immigrant Families With Young Children
Duh‐Leong, C., Tomopoulos, S., Nastro, A., Sharif, I., Ibanez-Gomez, L., Caprio, C. D., Nagpal, N., & Fierman, A. H. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02182-0 · Cited by 5
“Since about 20% of US children live in poverty, research has emerged about poverty-related social drivers of health including associations between food insecurity and obesogenic feeding styles (Gross et al., 2012), housing disrepair with infant and toddler sleep practices (Duh-Leong et al.”
BackgroundSelf-citation
Factors associated with infant feeding styles in the Federal District, Brazil
Coleta, H., Schincaglia, R. M., Gubert, M. B., & Pedroso, J. (2022) · Appetite · doi:10.1016/j.appet.2022.106290 · Cited by 5
The potential role of social care in reducing childhood obesity
Herrera, E. C., Figueroa-Nieves, A. I., & Baidal, J. W. (2023) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000001309 · Cited by 5
The Association Between Prenatal Food Insecurity and Breastfeeding Initiation and Exclusive Breastfeeding Duration: A Longitudinal Study Using Oregon PRAMS and PRAMS-2, 2008–2015
Silva, D. A. D., Anderson, E. A., Kim, J., Lee, M. T., & Thoma, M. E. (2024) · Breastfeeding Medicine · doi:10.1089/bfm.2023.0126 · Cited by 5
Policy, Systems, and Environmental Strategies to Support Healthy Eating Behaviors in Early Childhood: A Scoping Review of Existing Evaluation Tools
Varela, E., Shelnutt, K. P., Miller, D., Zeldman, J., & Mobley, A. R. (2024) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2024.07.160 · Cited by 8
Unpredictable Feeding Impairs Glucose Tolerance in Growing Lambs
Jaquiery, A. L., Oliver, M. H., Landon-Lane, N., Matthews, S. J., Harding, J. E., & Bloomfield, F. H. (2013) · PLoS ONE · doi:10.1371/journal.pone.0061040 · Cited by 5
Food Insecurity: Determinants and Impacts
Darmon, N., & Caillavet, F. (2017) · Springer eBooks · doi:10.1007/978-3-319-55942-1_9 · Cited by 5
A synthesis of early antecedents of eating behavior and weight status in girls: The legacy of girls’ NEEDS project
Balantekin, K. N., Moore, A. M., Ruggiero, C. F., & Savage, J. S. (2022) · Appetite · doi:10.1016/j.appet.2022.106052 · Cited by 5
Infant Feeding Varies Across Eating Behavior and Feeding Modalities in Mothers With Low Income
Kebbe, M., Altazan, A. D., Beyl, R. A., Gilmore, L. A., & Redman, L. M. (2022) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2022.03.004 · Cited by 5
Association between unmet social needs and healthy lifestyle parenting behaviors
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Prevalence and characterization of food insecurity in a Canadian paediatric emergency department
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The Longitudinal Relation between Infant Feeding Styles and Growth Trajectories among Families from Low-Income Households
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Food Insecurity and Parent Feeding Practices in Urban and Rural Children Aged 7–12 Years
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Exploring the associations of food and financial insecurity and food assistance with breastfeeding practices among first-time mothers
de Brito, J. N., Friedman, J., Johnson, S. T., Berge, J. M., & Mason, S. M. (2024) · Public Health Nutrition · doi:10.1017/s1368980024001514 · Cited by 3
“The burgeoning literature examining whether food insecurity and access to food assistance programs in the US influence breastfeeding duration has demonstrated inconsistent findings (4 – 6) .”
Background
The Relationship between Household SNAP Participation, Parent Feeding Styles, and Child Eating Behaviors
Bensignor, M. O., FREESE, R. L., Sherwood, N. E., Berge, J. M., Kunin‐Batson, A., Veblen‐Mortenson, S., & French, S. A. (2021) · Journal of Hunger & Environmental Nutrition · doi:10.1080/19320248.2021.1994506 · Cited by 2
Relationship Between Food Security Status in a Caregiver's Family of Origin and Current Feeding Practices Among Low-Income, Single, Female Primary Caregivers
Lappan, S. N., Harman, T., Pavela, G., & Hendricks, P. S. (2022) · Family & Community Health · doi:10.1097/fch.0000000000000347 · Cited by 2

Authors: Gross, R. S., Mendelsohn, A. L., Fierman, A. H., Racine, A. D., & Messito, M. J.
Affiliations: Albert Einstein College of Medicine (US)
New York University (US)
ORCID: Gross, Rachel S.
Mendelsohn, Alan L.
Fierman, Arthur H.
Racine, Andrew D.
Messito, Mary Jo
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2012-08-01
Volume: 130
Issue: 2
Pages: 254-261
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2011-3588
OpenAlex: W1999090626
Cited by: 131
References: 53
Citations by year: 2026: 7 · 2025: 10 · 2024: 11 · 2023: 9 · 2022: 11 · 2021: 13 · 2020: 14 · 2019: 9 · 2018: 10 · 2017: 8 · 2016: 6 · 2015: 12 · 2014: 8 · 2013: 2 · 2012: 1
FWCI: 13.08
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Funders: Centers for Disease Control and Prevention (T01CD000146)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Food Security and Health in Diverse Populations
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: food insecurity, infant feeding practices, maternal feeding styles, restrictive feeding, breastfeeding, juice consumption, low-income households, obesity prevention, WIC program
MeSH terms: Attitude to Health, Beverages, Body Weight, Breast Feeding, Edible Grain, Cross-Sectional Studies, Feeding Behavior, Female, Food Preferences, Food Supply, Hispanic or Latino, Humans, Infant, Infant Nutritional Physiological Phenomena, Male, Maternal Behavior, Mother-Child Relations, Obesity, Poverty, Risk Factors, United States, Urban Population, Infant Formula, White People, Overweight

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Food Insecurity and Obesogenic Maternal Infant Feeding Styles and Practices in Low-Income Families

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