The Associations between Caregivers' Emotional and Instrumental Feeding, Children's Emotional Eating, and Children's Consumption of Ultra-Processed Foods in China.

High consumption of ultra-processed foods (UPF) increases the risks of non-communicable diseases and all-cause mortality in adulthood, and the risk of early childhood caries. Limited evidence about factors influencing children's consumption of UPF exists. This study was conducted to assess the prevalence of UPF consumption among children less than three years of age, and identify its associations with caregivers' emotional and instrumental feeding, and children's emotional eating. A cross-sectional study was conducted in Shijiazhuang, Hebei Province, China. Caregivers caring for children aged 6-36 months (n = 408) were recruited. Caregivers' emotional and instrumental feeding practices and children's emotional eating were assessed by the Parents' Feeding Practices Scale for Infant and Young Child and Children's Eating Behaviour Questionnaire, respectively. Children's UPF consumption was assessed by a validated Food Frequency Questionnaire. Of the children, 86.8% consumed UPF. The highest percentage of UPF consumed was pastries (63.5%), followed by solid or semi-solid dairy products (58.8%), and reconstituted meat products (56.4%). Caregivers' emotional and instrumental feeding was positively associated with children's consumption of UPF (OR = 1.59, 95%CI: 1.01, 2.49), a higher frequency of UPF consumption weekly (OR = 1.80, 95%CI: 1.35, 2.39), and a larger amount of UPF consumption weekly (OR = 1.85, 95% CI: 1.38, 2.49). Children's higher frequency of emotional undereating was associated with their UPF consumption (OR = 1.61, 95%CI: 1.07, 2.42) and a higher frequency of UPF consumption weekly (OR = 1.33, 95%CI: 1.03, 1.73). Children's emotional undereating significantly mediated the associations between caregivers' emotional and instrumental feeding and children's consumption of reconstituted meat products. Caregivers should be educated to avoid emotional and instrumental feeding practices, and cultivate children's good eating habits to improve children's diet quality.

Recommendations for breastfeeding during Coronavirus Disease 2019 (COVID-19) pandemic.

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has spread worldwide. The safety of breastfeeding of SARS-CoV-2-positive women has not yet reached a consensus among the scientific community, healthcare providers, experts in lactation care, health organizations and governments. This study was conducted to summarize the latest evidence about the safety of breastfeeding among suspected/confirmed infected mothers and to summarize the recommendations on breastfeeding during COVID-19 from different organizations. METHODS: A comprehensive literature review of publications about the safety of breastfeeding among SARS-CoV-2-infected mothers was conducted. Scientific databases were searched up to 26 May 2021. The evidence was summarized into five perspectives according to a framework proposed by van de Perre et al. with certain modifications. Moreover, websites of different health organizations were visited to gather the recommendations for breastfeeding. RESULTS: The current evidence demonstrated that the majority of infants breastfed by infected mothers were negative for SARS-CoV-2. Breast milk samples from suspected/infected mothers mainly demonstrated negative results in SARS-CoV-2 viral tests. There was insufficient evidence proving the infectivity of breast milk from infected mothers. Recent studies found other transmission modalities (e.g., milk containers, skin) associated with breastfeeding. Specific antibodies in the breast milk of infected mothers were also found, implying protective effects for their breastfed children. According to van de Perre's criteria, the breast milk of infected mothers was unlikely to transmit SARS-CoV-2. Owing to the low quality of the current evidence, studies with a more robust design are needed to strengthen the conclusion regarding the safety of breastfeeding. Further studies to follow up the health status of infants who were directly breastfed by their suspected/infected mothers, to collect breast milk samples at multiple time points for viral tests and to examine specific antibodies in breast milk samples are warranted. Current recommendations on breastfeeding during COVID-19 from different organizations are controversial, while direct breastfeeding with contact precautions is generally suggested as the first choice for infected mothers. CONCLUSIONS: This review determined the safety of breastfeeding and identified the focus for further research during the COVID-19 pandemic. Recommendations on breastfeeding are suggested to be updated in a timely manner according to the latest evidence.

Paternal and maternal support of moderate-to-vigorous physical activity in children on weekdays and weekends: a cross-sectional study.

BACKGROUND: Most studies of associations between parental support behaviours for physical activity (PA) and children's moderate-to-vigorous physical activity (MVPA) have been conducted in developed countries, and they have focused on maternal or parental support behaviours. Children's MVPA time (i.e., weekdays vs. weekends) has not been adequately differentiated. This paper investigated the associations of paternal and maternal support behaviours for PA with the proportion of children who met the MVPA recommendations on weekdays and weekends in China. METHODS: Cross-sectional data of 517 father-child dyads and 1422 mother-child dyads were analysed. The children recorded PA diaries on 7 consecutive days to assess their MVPA time. The father or mother completed a questionnaire concerning their support for children's PA. Multivariate logistic regression was used to investigate the independent effects of paternal and maternal support behaviours for PA on whether children met the MVPA recommendations for weekdays, weekends, and the whole week. RESULTS: Significantly fewer children met the MVPA recommendations on weekends (37.8%) than on weekdays (62.8%). Higher paternal (odds ratio [OR] = 1.098, 95% confidence interval [CI]: 1.009-1.195) and maternal (OR = 1.076, 95% CI: 1.021-1.134) total support behaviour scores were associated with higher odds of children meeting the MVPA recommendations on weekends, after controlling for covariates. Paternal PA knowledge-sharing with the child was positively associated with children meeting the MVPA recommendations on weekends (OR = 1.319, 95% CI: 1.055-1.649); it tended to be associated with children meeting the MVPA recommendations on weekdays and throughout the week, although these associations were not statistically significant. Maternal reservation of PA time for the child was positively associated with a higher likelihood of children meeting the MVPA recommendations on weekdays (OR = 1.160, 95% CI: 1.025-1.313), weekends (OR = 1.241, 95% CI: 1.097-1.403), and throughout the week (OR = 1.214, 95% CI: 1.076-1.369). CONCLUSIONS: Paternal and maternal support behaviours for PA should be enhanced on weekends to increase children's MVPA. Fathers should share PA knowledge with children and mothers should reserve PA time for children every day.

Maternal feeding practices and toddlers' fruit and vegetable consumption: results from the DIT-Coombe Hospital birth cohort in Ireland.

BACKGROUND: Health benefits of fruit and vegetable have been well recognized. However, insufficient consumption of fruit and vegetable is prevalent among toddlers, and has become a global public health issue. Maternal feeding practices are potential factors influencing toddlers' dietary intake, including fruit and vegetable intake. This study was conducted to explore the influence of maternal feeding practices on toddlers' fruit and vegetable consumption in Ireland. METHODS: A follow-up to the DIT-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to participate in the present follow-up study by phone. A questionnaire assessing maternal feeding behavior and the child's 3-day food diary was sent to mothers who agreed to take part in the present study by post, together with a self-addressed stamped envelope. RESULTS: There were 193 mother-children pairs included in the analysis, and the mean age of children was 2.4 (SD 0.7) years old. Toddlers' mean daily intakes of vegetable and fruit were 67.57 (SD 45.95) g and 213.35 (SD 170.78) g, respectively. Logistic regression analyses showed that maternal practice of breastfeeding for more than 4 weeks was positively associated with fruit (OR = 2.93, 95% CI: 1.29-6.64) and vegetable (OR = 1.95, 95% CI: 1.00-3.81) intake or the contribution of fruit (OR = 2.62, 95% CI: 1.19-5.80) and vegetable (OR = 2.02, 95% CI: 1.02-3.99) to the total diet. Letting the child eat with other family members was associated with high vegetable intake (OR = 5.45, 95%CI: 1.69-17.61) and high contribution of vegetable to total diet (OR = 3.78, 95% CI: 1.04-13.82). Not being too worried about the child's refusal to eat was positively associated with toddlers' vegetable intake (OR = 2.10, 95%CI: 1.09-4.05). CONCLUSIONS: To increase children's fruit and vegetable intake, and develop good eating habits, parents should eat with their toddlers, be patient and not put much pressure on their children in the context of meal feeding.

Are Maternal Feeding Practices and Mealtime Emotions Associated with Toddlers' Food Neophobia? A Follow-Up to the DIT-Coombe Hospital Birth Cohort in Ireland.

This study was conducted to explore the associations between maternal feeding practices, mealtime emotions, as well as maternal food neophobia and toddlers' food neophobia in Ireland. A follow-up to the Technological University Dublin (DIT)-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to the present study by telephone calls. Postal questionnaires with stamped addressed envelopes were distributed to those who agreed to participate in the study. Toddler food neophobia was assessed by the modified version of the Child Food Neophobia Scale (CFNS). There were 205 participants included in this study, with a median score of child food neophobia of 12. A higher degree of child food neophobia (score > 12) was positively associated with the maternal practice of coaxing the children to eat at refusal (OR (Odds Ratio) = 2.279, 95% CI: 1.048-4.955), unpleasant emotions at mealtime (e.g., stressful or hectic for mothers, or tearful for children) (OR ranged between 1.618 and 1.952), and mothers' own degree of food neophobia (OR = 1.036, 95% CI: 1.001-1.072). Mothers who were not worried when confronted with child's food refusal was negatively associated with toddlers' food neophobia (OR = 0.251, 95% CI: 0.114-0.556). This study suggests the maternal practices of responsive feeding, being calm and patient with the toddlers, and creating a positive atmosphere at mealtime.