Search Results (162)

Background/Objectives: Infant regulatory disorders (RDs) describe the infants’ difficulties in regulating their physiological and emotional states, manifesting in problems with sleeping, feeding, or excessive crying. A post hoc analysis of data from the German SKKIPPI cohort study investigated the association of maternal smartphone use and the occurrence of RDs. Methods: In a randomly drawn sample from three local population registers, a self-administered online questionnaire was used to collect basic sociodemographic data, smartphone use behavior and the mother’s subjective perception of the infant’s RD. In case of psychosocial burden of the mother, a structured psychiatric-diagnostic interview (M.I.N.I.) was conducted and the Questionnaire for Crying, Feeding and Sleeping (SFS) was completed. Results: Of the 5954 parent–child dyads completing the online-questionnaire, 3.7% reported frequent smartphone use while interacting with the child, compared with 5.8% of the 972 mother–child dyads in the psychiatric interview. Among frequent smartphone users, 61.5% indicated RD compared to 41.6% of the infrequent users (p = 0.005). After adjustment for confounding by psychiatric disorder, educational level, single parent status, and age, perceived stress when interrupted during smartphone use was consistently associated with less favorable outcomes (OR of feeding easy 0.56, 95% CI 0.42; 0.75; OR of falling asleep easily 0.85, 95% CI 0.73; 0.99; OR of excessive crying 1.37, 95% CI 1.04; 1.81). RD based on the SFS was associated with elevated stress during smartphone use (OR 1.87, 95% CI 1.35; 2.58). Conclusions: Maternal stress when smartphone use is interrupted is more strongly associated with early regulatory difficulties than frequency of smartphone use alone, indicating the importance of also considering emotional and contextual factors in the analysis of technology use during parent–child interactions. Full article

A thorough understanding of the natural history and biology of any species of concern is vital to improving their conservation outlook. There are several possible impediments that can arise in compiling the necessary data to have such a measurable impact. The species belonging to the genus Oophaga display brilliant coloration that varies within and between species and extensive parental care that make this group unique among amphibians and highly recognizable to people around the world. The Large Colombian Oophaga, historically known as the histrionica–lehmanni species complex, is a group comprising five distinct species with varying color patterns, preferred habitats, and alkaloid profiles. These species are greatly understudied and there are considerable knowledge gaps about their biology and conservation status, ranging from species distributions and population structures to fecundity and development. These gaps can complicate efforts to conserve them both in their natural habitats and in ex situ efforts. Here we have compiled findings in the published literature on this unique clade of amphibians in an attempt to synthesize available knowledge on their natural history and evolution and alert the reader to ongoing threats. We provide species descriptions, including known ranges and localities, feeding ecology, and reproductive behaviors, as well as current conservation efforts to guard against emergent threats, namely habitat loss and the illegal pet trade. The species profiled here represent a clade of amphibians that are unique in their natural histories and very much in need of further investigations to improve our knowledge base. It is the goal of the authors for this compilation to serve as a starting point for conservation efforts and a springboard for further research on this fascinating group. Full article

Background/Objectives: Dental caries in primary dentition is strongly related to daily oral hygiene routines and sugar-related dietary behavior. This study assessed oral hygiene and dietary behaviors associated with the clinical severity of carious lesions in primary dentition. Methods: This observational, cross-sectional, clinical-record-based study assessed 448 pediatric dental records from children examined in Craiova, Romania. After applying predefined eligibility criteria, 400 parent–child pairs were included. Children were aged 3–6 years and had primary or early mixed dentition with predominant primary teeth. Carious lesions were classified as absent, incipient, cavitated non-complicated caries, or advanced caries with pulpal/periapical involvement. The primary analysis focused on toothbrushing onset and frequency, toothbrush and toothpaste type, night feeding duration, sweets intake, and sweetened or carbonated beverage intake. Logistic regression was used to identify factors associated with higher odds of major carious lesions. Secondary clinical-record variables were analyzed exploratorily. Results: Carious lesions were recorded in 331 children, while 69 children were caries-free. Incipient caries, cavitated non-complicated caries, and advanced caries with pulpal/periapical involvement were recorded in 99, 116, and 116 children, respectively. Child age and sex were not significantly associated with caries severity. In the adjusted model, delayed toothbrushing onset (OR = 1.464; 95% CI: 1.148–1.866; p = 0.002) and sweetened beverage consumption (OR = 2.488; 95% CI: 1.561–3.963; p < 0.0005) remained independently associated with major carious lesions after Bonferroni correction. Conclusions: In this sample, major carious lesions in primary dentition were associated mainly with modifiable postnatal behaviors, particularly delayed initiation of toothbrushing and sweetened beverage intake. Due to the cross-sectional design, the findings should be interpreted as associations, not causal relationships. Full article

Eating behavior and eating habits are shaped from the earliest stages of life through interactions among biological, familial, social, and environmental factors. The aim of this narrative review is to integrate evidence on the early-life determinants of eating behavior and their influence on dietary intake from infancy to adolescence. A narrative review was conducted with a structured search approach prioritized on longitudinal studies, intervention trials, and policy evaluations when available, and using cross-sectional evidence mainly to describe patterns and sociodemographic factors. Synthesizing the current evidence, our framework proposes that breastfeeding, responsive complementary feeding, and self-regulatory parenting are associated with higher responsiveness to internal hunger, satiety cues, and preference for nutrient-dense foods. Conversely, coercive practices, early exposure to highly palatable foods, and the influence of food marketing are linked to dominant hedonic responses and impulsive consumption patterns. Furthermore, family environments characterized by stress or food insecurity, together with high access to low-nutrient foods, may increase vulnerability to poor eating habits and emotional eating during adolescence. Overall, the evidence highlights the need for preventive interventions that integrate parenting support, school food education, digital marketing regulation policies, and the promotion of healthy food environments across multiple sectors. Understanding the biological, psychological, and social factors linking early determinants to dietary intake and eating behaviors across development is essential for promoting a balanced relationship with food and preventing chronic diseases from an early age. Full article

Background/Objectives: Excess consumption of energy-dense foods (EDF; ultra-processed snacks, sweets, and sugar-sweetened beverages) among preschool-aged children is a public health concern, particularly in low-income families. Caregiver parenting style, psychological stress, and food-parenting practices (FPP) may shape children’s EDF consumption, yet little is known about how these factors operate in real time. This exploratory pilot study examined (1) associations between baseline characteristics and EDF feeding episodes across 1 week and (2) whether caregivers’ momentary stress during EDF episodes related to FPP used. Methods: In total, 22 caregivers of Head Start children (ages 3–5) completed baseline measures and 7 days of ecological momentary assessment (up to seven prompts/day). At each prompt, caregivers reported child EDF consumption in the past hour; if confirmed, they reported FPP used and rated momentary stress. Aim 1 used Poisson regression to model caregiver-level EDF episode counts. Aim 2 tested momentary stress–practice associations during EDF episodes using GEE, with within-person and between-person stress modeled separately. Results: Authoritarian parenting was associated with a higher weekly rate of EDF episodes (RR = 1.43, 95% CI 1.23–1.66, p < 0.001); authoritative parenting trended lower (RR = 0.90, p = 0.065). Higher baseline stress was associated with more EDF episodes (RR = 1.25, p = 0.001). Momentarily, elevated stress above a caregiver’s own average increased odds of using food as a reward (OR = 1.08 per +10 points, p = 0.011), while higher average momentary stress was associated with co-eating (OR = 1.59, p = 0.042). Domain-level FPP composites showed no association with momentary stress. Conclusions: Authoritarian parenting and higher caregiver stress were associated with increased EDF feeding, and momentary stress was linked to reward-based feeding during those episodes. These hypothesis-generating findings suggest potential behavioral targets for just-in-time adaptive intervention, pending replication in adequately powered studies. Full article

Background/Objectives: Infant regulatory problems (RPs) are at risk of persisting and can contribute to later behavioral difficulties. Parenting stress has been identified as a risk factor associated with child RPs, but its mediating role has rarely been investigated in this context. The aim of the study was (1) to investigate whether RP symptoms were related to subsequent infant RP symptoms/toddler behavioral and emotional problems (BEPs) between two pediatric check-ups in the first 3 years of life and (2) to investigate the potential role of parenting stress as a partial mediator in the association of infant RPs and subsequent RPs/BEPs. Methods: Using data from a German cohort study (CoronaBaBY), associations between infant RPs at baseline and RPs/toddlers BEPs at follow-up (around 8 months later) were analyzed. Parenting stress was included as a mediation variable into the model. Results: In total, 725 parent–child dyads were analyzed. Mean infant age was 5.0 months (SD = 3.4). Elevated RP symptoms at baseline significantly predicted infant RP symptoms and BEPs at follow-up. Parenting stress at baseline significantly predicted feeding problems and BEPs at follow-up. Parenting stress partially mediated the associations between baseline infant RPs and follow-up RPs respectively BEPs in most models. Conclusions: Interventions should consider the partially mediating role of parenting stress, especially for the later development of BEPs. Research should aim to identify additional factors influencing infant regulatory problems and subsequent behavioral difficulties. Full article

Background: Encouraging fruit and vegetable (FV) consumption early in childhood is important for long-term healthy eating. Though parents play an important role in shaping children’s FV-related taste preferences and consumption, validated instruments assessing the range of parenting practices that specifically support young children’s FV intake are scarce. Furthermore, little attention has been given to low-income families, cultural inclusivity, and FV practices across different settings. The current study sought to conduct an initial examination and explore the measurement equivalency of a new FV parenting practices questionnaire (FVPPQ) across racially/ethnically diverse groups that address these gaps. Methods: Data for this paper came from a large project focused on parents’ FV parenting practices with young children enrolled in Head Start programs in the southern part of the U.S. Inclusion criteria were (a) parent/legal guardian being eighteen or older, (b) being the primary person responsible for child feeding, and (c) the child not requiring a special diet (e.g., diabetic). Using a multi-phases project approach, we (1) developed a preliminary conceptual map of parenting practice domains by reviewing existing measures on FV parenting practices; (2) completed and content-analyzed data from 18 focus groups (n = 62) to identify and further revise the preliminary conceptual map of domains, (3) administered a questionnaire with 11 domains of FV parenting practices, and then (4) empirically explored and reduced the measure while evaluating its content, construct, and criterion validity, and cultural equivalency across Non-Hispanic White, Hispanic White, and Black parents (n = 281). Results: Findings from Phases 1 and 2 generated a 107-item questionnaire that was reduced during phase 3 through a series of principal component and confirmatory factor analyses to the final FVPPQ with 21 items in four unique domains, showing good variability and inter-item consistency reliability: (1) Availability (5 items); (2) modeling (5 items); child-focused (5 items); and pressure (6 items). Three of the four domains evidenced cultural equivalency. Conclusions: The FVPPQ with four unique subscales demonstrated good content, construct validity, and partial measurement equivalency across racially/ethnically diverse groups of parents. Further confirmatory validation is warranted in larger samples, but the FVPPQ might be a promising and easily administered measure for research and applied interventions in nutrition, health behavior, and parenting contexts. Full article

Objectives: Early childhood caries (ECC) remains a significant global health issue. COVID-19 disrupted protective factors such as in-office parental support and routine dental screenings. This study investigates caries prevalence and severity in Hungarian toddlers (<3 years) born during the lockdown, compared with pre-pandemic data from 2019. Methods: A serial cross-sectional study was conducted through nursery-based dental screenings and a parental questionnaire. Key indices (caries prevalence; average number of decayed, missing, and filled tooth—dmf-t index; Significant Caries Index—SiC-index; and Restorative Index—RI) were calculated and analyzed in relation to parental education and knowledge of caries etiology. The results were compared to 2019 data. Results: A total of 636 children were examined; 274 (mean age: 29.37 ± 4.56 months) were part of the 2024 cohort. Caries prevalence decreased from 15.46% in 2019 to 13.87%. The mean dmf-t index also declined significantly (0.685 ± 2.20 vs. 0.383 ± 1.29; p = 0.025). Initial feeding practices, such as exclusive breastfeeding, were positively linked to later liquid intake habits (p < 0.01). Prenatal information did not affect caries rates or cariogenic liquid consumption. While parental education level was significantly related to caries prevalence and feeding practices in 2019, its influence was less marked in the 2024 cohort. Conclusions: ECC prevalence declined slightly among children born during the pandemic but remains high. Prenatal education did not promote healthier feeding-related oral health behaviors or outcomes. The reduced impact of parental education post-lockdown may suggest that heightened general health awareness during the pandemic lessened education-based disparities. Full article

Background/Objectives: Childhood obesity remains a major public health issue, particularly in Mediterranean countries such as Greece. Although parental influences on children’s weight have been extensively studied, fewer studies have jointly examined parental mental health, feeding practices, sociodemographic factors, and biological stress markers. This study aimed to investigate associations between psychological status, educational level, feeding behaviors, and children’s Body Mass Index (BMI) in a Greek sample. A pilot assessment of salivary cortisol was included in evaluating its feasibility as an objective biomarker of parental stress. Subjects and Methods: A total of 103 parent–child dyads participated in this cross-sectional study. Children’s BMI was classified using World Health Organization (WHO) growth standards. Parental stress, anxiety, and depressive symptoms were assessed using the Perceived Stress Scale-14 (PSS-14) and the Depression Anxiety Stress Scale-21 (DASS-21) questionnaires. Feeding practices were evaluated with the Comprehensive Feeding Practices Questionnaire (CFPQ). Statistical analyses included Pearson correlations, independent samples t-tests, one-way ANOVA, Mann–Whitney U, and Kruskal–Wallis tests. A subsample provided saliva samples for cortisol analysis to assess feasibility and explore the potential associations with parental stress indicators. Results: Parental BMI showed a strong positive association with child BMI (p = 0.002). Higher parental anxiety (p = 0.002) and depression (p = 0.009) were also associated with increased child BMI. Restrictive (p < 0.001) and emotion-driven (p < 0.001) feeding practices were associated with higher child BMI, whereas monitoring (p = 0.013) and health-promoting feeding practices (p = 0.001) appeared protective. Lower parental education was related to a higher BMI in both parents (p = 0.001) and children (p = 0.002) and to more frequent use of restrictive feeding strategies (p = 0.001). WHO charts identified a greater proportion of children as overweight or obese compared with the Centers for Disease Control and Prevention (CDC) criteria. The analysis showed statistically significant differences between the two classification systems (χ² (4) = 159.704, p < 0.001), indicating that BMI categorization varies considerably depending on the reference system used. No significant associations were observed with residential environment or salivary cortisol, likely due to the limited size of the pilot biomarker subsample. Conclusions: The findings highlight the combined effect of parental mental health status, educational level, and feeding practices on child BMI within the Greek context. The preliminary inclusion of a biological stress marker provides added value to the existing research in this area. These results underscore the importance of prevention strategies that promote parental psychological wellbeing and responsive feeding practices while addressing socioeconomic disparities to reduce the childhood obesity risk. Full article

Background/Objectives: Feeding difficulties in childhood can persist over time, affecting health and family dynamics. Timely identification is crucial to prevent atypical eating behaviors and nutrition-related consequences. However, data on childhood feeding difficulties remain limited. This study provides the first pilot characterization of eating behaviors among Italian children aged 5–11 years in order to characterize feeding difficulties, identify protective or detrimental factors, and assess relationships with anthropometric indices or blood pressure. Methods: In 2023, a 1-year cross-sectional pilot study was launched by the Società Italiana delle Cure Primarie Pediatriche involving child–parent dyads. Family pediatricians collected anthropometric data and blood pressure, after which parents completed an online questionnaire purposely developed for this study. The questionnaire generated a feeding difficulty score (0–10) where higher values reflected greater risk of atypical eating behaviors. Scores were categorized as follows: low risk (0–1), intermediate risk (2–6), and high risk (7–10). Results: A total of 742 questionnaires were collected. Overall, 19.8% of the children were categorized as high risk (7–10) for atypical behavior, 43.8% as intermediate risk (2–6), and 36.4% as low risk (0–1). Children with two omnivorous parents showed significantly lower odds of feeding difficulty scores at or above any threshold (OR 0.46, 95% CI 0.30–0.71; p < 0.0001). Borderline associations were observed for a breastfeeding duration of at least 9 months (OR 0.79, 95% CI 0.61–1.02; p = 0.075) and baby-led weaning (OR 0.72, 95% CI 0.52–1.00; p = 0.053). High-risk children had a significantly lower BMI percentile with respect to the other groups. Conclusions: A significant proportion of Italian children aged 5–11 years exhibited moderate to severe risk of atypical behaviors. Parental eating appears to play a key role in shaping children’s eating behaviors in middle childhood, underscoring the pivotal role of pediatricians in guiding families. Further research and targeted strategies are needed to prevent childhood feeding difficulties. Full article

Mothers’ behavior strongly influences children’s eating habits, with family attitudes and feeding practices playing a key role in dietary development. In accordance with the previous literature, this study examined these aspects, including also mothers’ use of social media to stay informed about nutrition as an innovative element. The main goal was to validate the Italian version of the PSEPAD scale (Parental Self-Efficacy for Promoting Healthy Physical Activity and Dietary Behaviors in Children), which is a valid and reliable tool for assessing parental self-efficacy in encouraging healthy lifestyles in children, through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The sample was composed of 217 mothers. Results were interpreted through groups comparisons (chi-square, ANOVA, and t-test). The findings confirmed the central role of mothers in managing children’s diets and using strategies against picky eating behaviors. The study also highlighted the growing use of social media among mothers, especially younger ones, as a source of nutritional information, meal planning, and peer support, despite a generally low level of satisfaction with the content available on pediatric nutrition. Finally, the results showed a positive link between maternal self-efficacy and healthier child behaviors: mothers with higher self-esteem and confidence were more effective in promoting healthy habits. These findings underscore the importance of targeted interventions to strengthen maternal self-efficacy and the development of digital tools to support healthy family lifestyles. Full article

Background: Parents play a central role in shaping children’s eating behaviors. While previous research has documented associations between parental attitudes and feeding practices, fewer studies have examined how mothers’ own eating styles may contribute to their perceptions of their children’s eating attitudes and behaviors and how these may influence subsequent feeding practices. Objectives: To our knowledge, this is the first study to examine whether mothers’ eating styles predicted their self-reported restrictive feeding practices indirectly through their perceptions of their children’s appetite and subsequently through their concern about their children’s weight. Methods: A total of 488 mothers (M_age = 33.87 years, SD = 4.81, range = 20–49) of children aged 2–7 years (M_age = 3.85 years, SD = 1.33) completed self-report measures, including the Dutch Eating Behavior Questionnaire (DEBQ) for maternal eating styles, the Child Feeding Questionnaire (CFQ) for parental concerns and restrictive practices, and the Children’s Eating Behavior Questionnaire (CEBQ) for perceptions of child eating attitudes. Structural equation modeling (SEM) was employed to test the hypothesized mediation model, with model fit evaluated using CFI, TLI, RMSEA, and SRMR indices. Results: Our proposed model demonstrated good fit (CFI = 0.94, RMSEA = 0.07) and showed that maternal eating styles were positively associated with perceived child appetite (β = 0.44, p < 0.001). Perceived appetite predicted both maternal concern about child weight (β = 0.39, p < 0.001) and restrictive feeding practices (β = 0.28, p < 0.001), while maternal concern strongly predicted restriction (β = 0.65, p < 0.001). The total indirect effect from maternal eating styles to restriction was significant (β = 0.23, p < 0.001), and the model explained 56% of the variance in restrictive feeding. Conclusions: Our findings suggest that maternal eating styles may bias mothers’ perceptions of their children’s appetite and indirectly influence restrictive feeding practices primarily through increased concern about child weight. Given the cross-sectional design, reliance on maternal self-report, and online convenience sampling, results should be interpreted cautiously. Nonetheless, the study provides the first evidence for a sequential pathway linking maternal eating styles, child appetite perceptions, and weight concern to restrictive feeding, highlighting cognitive and perceptual processes as intervention targets. Full article

Background: Picky eating (PE), also termed food selectivity, is one of the most common feeding concerns in childhood. Although often a transient developmental stage, persistent or severe selectivity may lead to nutritional deficiencies, growth impairment, and psychosocial consequences. Methods: This narrative review is based on literature searches conducted in April 2025 across PubMed, Web of Science, Embase, Medline, and Google Scholar. Articles published between 2015 and 2025 were included if they addressed the epidemiology, etiology, assessment, or management of PE in children aged 0–18 years. Additional seminal references predating this period were also considered. Results: Prevalence estimates of PE vary widely (13–50%), with peak incidence between ages two and six. Contributing factors include genetic predisposition, sensory sensitivities, temperament, family feeding practices, environmental influences, and adverse feeding experiences. Distinction from avoidant/restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD) is essential, as these conditions carry greater risk of nutritional and psychosocial impairment. Assessment relies on caregiver-report instruments, clinical observation, growth monitoring, and targeted nutritional evaluation. Effective management integrates parental education, responsive feeding strategies, repeated exposure to novel foods, and, when indicated, nutritional supplementation or referral to multidisciplinary teams. Sensory-based therapies, behavioral interventions, and psychoeducational programs show particular benefit in persistent cases. Conclusions: While most children outgrow PE without adverse outcomes, a subset remains at risk of long-term nutritional compromise and psychosocial difficulties. Early recognition, family-centered guidance, and evidence-based interventions are essential. Future research should refine diagnostic criteria, develop culturally sensitive assessment tools, and evaluate innovative therapies to improve outcomes. Full article

Clarifying the influence of sensorimotor factors on feeding participation problems (FPPs) in children with autism may have implications for therapeutic interventions. Our objective was to assess the prevalence of FPPs in a population of children with autism and to study its association with sensorimotor factors (oral and tactile reactivity and oral praxis). Descriptive observational study including 26 autistic children aged 3 to 12 years. Behavioral Pediatrics Feeding Assessment Scale (BPFAS), Sensory Profile 2 (SP-2), and Oral Praxis (OPr) tests were used. Caregiver stress was evaluated by Parental Stress Index–Short Form (PSI-4-SF). Multivariate logistic analysis and Receiver Operating Characteristic curve was used to predict the risk of FPPs. 26 children (84.6% boys) were included, with a mean age of 6.92 years (95% CI 5.94–7.91). Feeding behavior difficulties were observed in 53.8% of participants, 80.7% exhibited oral praxis issues, and 65.4% of caregivers reported stress related to their child’s FPPs. Oral reactivity and sensory avoidance behaviors were significantly associated with FPPs. Among children with higher support needs, tactile reactivity was also significantly related to FPPs. FPPs in children with autism were associated with oral and tactile hyperreactivity, higher levels of sensory avoidance, dysfunctional parent–child interactions, and increased support needs. Full article

Background: Nutrition problems among primary school children increase the risk of illness, reduce school attendance, and impair academic performance. The Indonesian national school feeding program (ProGAS—Program Gizi Anak Sekolah) was developed to address these issues through the provision of healthy breakfast, nutrition education, and character building. Methods: This study employed a mixed-methods design involving 454 primary school students aged 8–14 years from 24 schools across four provinces. Data collection included structured questionnaires, 24 h dietary recalls, and anthropometric measurements. In-depth interviews with school principals, teachers, cooking teams, parents, students, nutritionists, and district education office staff were conducted to capture experiences and opinions on the ProGAS implementation. Results: ProGAS significantly improved students’ dietary diversity, meal frequency, handwashing with soap, and nutrition knowledge, alongside a positive trend in school attendance. Improvements included higher mean dietary diversity, increased proportion of students eating ≥3 meals/day, greater correct responses on balanced nutrition, and higher rates of handwashing before meals (all p < 0.01). Children also developed positive behaviors such as praying before meals, queuing, and taking responsibility for cleaning dishes. However, students’ breakfast habits did not significantly improve, the delivery of nutrition education was suboptimal, and no significant changes were observed in nutrient intakes or nutritional status based on BMI-for-age. While the energy and protein contributions of the ProGAS menu met the recommended 25–30% of daily requirements for breakfast, its micronutrient contributions remained below the recommended levels. Key management gaps include the delivery of nutrition education to students and the monitoring of implementation by local and national authorities. Conclusions: ProGAS demonstrated positive impacts on some dietary and hygiene practices as well as learning environment. To achieve greater improvements in breakfast habits, nutrient intake and nutritional status, it is recommended to strengthen the school feeding menus not only for dietary diversity but also for nutrient density, enhance capacity building for teachers, deliver regular and engaging nutrition education, and reinforce program monitoring. Full article