COVID-19 forced a shift from healthy feeding practices by parents of young children

Efforts to contain the spread of COVID-19 have dramatically changed the day-to-day lives of families in the U.S. and around the world. Families have experienced disruptions to education and childcare, recreational activities and social support. At the same time, many parents have been forced to adapt to significant changes in work, school and childcare schedules. 

Published in the journal Appetite, a study led by Katie Loth, PhD, MPH, an assistant professor of family medicine in the University of Minnesota Medical School, explored how parents changed approaches to feeding their children during the pandemic. This study was a partnership with the U of M School of Public Health and Temple University’s College of Public Health.

“Parenting during the COVID-19 pandemic was challenging for most families,” Loth said. “Understandably, we found that many families shifted their approach to feeding their child during this time as well. We found that during the pandemic, the parents in our study were less structured in their approach to feeding compared to before the pandemic — using fewer rules and limits, less routine, and less frequent modeling — and that parents engaged in fewer behaviors known to support children's independence around eating, such as involving children in food prep, talking to children about the foods they were being served or providing children with praise and encouragement for trying new foods.”

“The pandemic has been awful for many, and shifts in approach to feeding and mealtime routines are expected and reasonable. Now, we want to help folks get back on track to the extent that we are able,” Loth said. 

This study examined parents’ approaches to feeding using data collected prior to the COVID-19 pandemic compared to data collected during the pandemic. They also looked at how parent stress, mood and child behavior influenced any observed changes. These were their key findings:

• Most parents of preschoolers use a wide range of food parenting practices that span four higher-order domains of coercive control (e.g., food restriction, pressure-to-eat), indulgence (e.g., short-order cooking, provision of food in response to emotions), structure (e.g., rules and routines) and autonomy support (e.g., guided choices, praise). 

• The use of food-related parenting practices known to be associated with more healthful dietary intake and eating patterns in children (i.e., structure and autonomy support behaviors) decreased during the COVID-19 pandemic. No changes in use of coercive control or indulgence feeding practices were observed. 

• Parent and child mood also played a role in observed changes. Negative parent mood during COVID-19 was associated with higher levels of coercive control and lower levels of structure, whereas positive child mood was associated with greater use of autonomy  supportive practices. 

“Overall, findings from the study indicate that parents of preschool-aged children used lower levels of structure and autonomy support during COVID-19,” Loth said. “Additionally, we saw that parent and child mood played an important role in observed differences. Observed differences were expected and are understandable given the immense challenges faced by families during the past 18 months.”

“It is essential that public health advocates, policy makers and primary care providers seek opportunities to support families in re-establishing healthful eating routines for their children as they emerge from this pandemic,” Loth said.    

Additional research is needed to better understand the role of the emotional climate of feeding on food parenting as well as to tailor intervention strategies to help parents maintain supportive feeding practices in the face of challenging situations. Loth is working to disseminate these findings to policy makers and providers with the goal of helping parents successfully navigate out of the pandemic and work towards reestablishing healthful eating routines. 

Funders for the study were National Institutes of Health Clinical and Translational Science Award, National Heart Lung and Blood Institute and Institute of Child Health and Human Development. The co-authors listed on the study are U of M faculty Ziyu Ji, Julian Wolfson, Jerica Berge, Dianne Neumark-Sztainer and Temple University faculty Jennifer Fisher.

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