Early feeding practices and eating behaviour in preschool children: The CORALS cohort

Abstract

This study aimed to investigate if the duration of breastfeeding and the method at initiation of complementary feeding affect eating behaviour in children aged 3-6 years. This is a cross-sectional analysis from the Childhood Obesity Risk Assessment Longitudinal Study project, an ongoing longitudinal cohort study that aims to identify childhood obesity risk factors in Spanish children. A total of 1215 children aged 3-6 years were included. Breastfeeding duration and the method of initiation of complementary feeding [baby-led weaning (BLW), traditional/spoon or mixed method] were evaluated. Eating behaviour at 3-6 years was assessed with the Child Eating Behaviour Questionnaire. Generalized linear models were fitted to assess the association between the aforementioned exposures and eating behaviour. Children breastfed for ≥4 months were less likely to be fussy eaters at 3-6 years compared to those breastfed for <1 month (OR: 0.86 95% CI: 0.76-0.98; p = 0.031). Compared to those children using the traditional/spoon-feeding method, those initiating complementary feeding through BLW or through a mixed approach were more likely to have higher scores on the enjoyment of food (EF) (OR, 95% CI: 1.33, 1.13-1.57; p = 0.001 and 1.17, 1.05-1.30; p = 0.002, respectively) and lower scores on food fussiness (FF) at 3-6 years (0.76, 0.62-0.91; p = 0.004 and 0.87, 0.78-0.98; p = 0.033, respectively). Breastfeeding for ≥4 months and initiation of complementary feeding with the BLW and a mixed approach were associated with greater EF and lower FF, which should endure practice.

Keywords: appetite; breastfeeding; childhood; complementary feeding; eating behaviour; feeding methods; infant.

Figure 1

Study flowchart of the participants from the CORALS study. CEBQ, child eating behaviour questionnaire; CORALS, Childhood Obesity Risk Assessment Longitudinal Study.

Figure 2

Mean scores for CEBQ scales according to breastfeeding duration and complementary feeding method categories: (a) Food avoidance subscales for the duration of breastfeeding. (b) Food approach subscales for the duration of breastfeeding. (c) Food avoidance subscales for complementary feeding methods. (d) Food approach subscales for complementary feeding methods. *ANOVA test; significant differences (p < 0.05) between EBF <1 versus >4 months for food fussiness (FF) and desire to drink (DD), and EBF for 1−3 versus >4 months for enjoyment of food (EF). Significant differences (p < 0.05) between the traditional/spoon‐feeding method versus BLW and mixed feeding for FF and EF, traditional/spoon‐feeding versus BLW for DD and versus mixed feeding for emotional undereating. BLW, baby‐led weaning; CEBQ, child eating behaviour questionnaire; EBF, exclusive breastfeeding.

Figure 3

Odds ratios (95% CI) for CEBQ subscales according to breastfeeding categories: (a) Food approach subscales. (b) Food avoidance subscales. *Ref. <1 month. Adjusted by child's sex, birthweight for gestational age, maternal age and education. CEBQ, child eating behaviour questionnaire.

Figure 4

Odds ratios (95% CI) for CEBQ subscales according to complementary feeding methods: (a) Food approach subscales. (b) Food avoidance subscales. *Ref, Traditional/spoon‐fed. Adjusted by child's sex, birthweight for gestational age, maternal age and education and duration of breastfeeding. CEBQ, child eating behaviour questionnaire.