Examining the Relationships between Parental Mental Health, Feeding Styles and Weight in Formula-Fed Infants

Abstract

Formula-fed infants are at greater risk for obesity compared to breastfed infants; however, some families are not able to or choose not to breastfeed. Parental feeding styles have been associated with infant weight, and parents of infants experience stress, depression, and anxiety for a variety of reasons. The first year of life is a critical period for establishing optimal nutrition, and little is known about the relationships between parental mental health and feeding styles during infancy especially among formula-feeding families. Guided by El-Behadli and colleagues' Extended UNICEF Care Model, this study used a descriptive cross-sectional survey design to examine relationships between parental mental health and feeding styles in parents of healthy, term formula-fed infants residing in the United States. In this study, 306 parents were recruited from parenting and infant feeding-related Facebook groups and local pediatricians' offices. Participants completed demographic and infant feeding background information, Infant Feeding Style Questionnaire (IFSQ), Patient Health Questionnaire Depression Module (PHQ-9), Generalized Anxiety Disorder Assessment (GAD-7), and Perceived Stress Scale (PSS-10). Descriptive statistics were used to analyze demographic data and determine prevalence of feeding styles. Sequential logistic regression was used to examine how well stress, depression, and anxiety predicted whether parents predominantly exhibited the non-responsive feeding style based on self-report. Findings concluded that reduced time spent on infant feeding and high levels of depressive symptoms along with low levels of anxiety and stress were the strongest predictors of non-responsive feeding. Most of our sample (56.5%) predominantly exhibited non-responsive feeding styles. Additionally, fathers more commonly exhibited non-responsive feeding styles compared to mothers, and there was a significant relationship between participants who were enrolled in WIC and non-responsive feeding styles. Our findings indicate a need for increased infant feeding support for parents, especially those experiencing depressive symptoms. Additionally, infant feeding support by healthcare professionals and in WIC programs is warranted for all parents, including those who formula-feed. Finally, there is a need to include fathers in infant feeding education and future research studies.