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Preventing Obesity with Responsive Feeding

While many factors can increase the risk of obesity in early childhood, parents and caregivers serve an important role in obesity prevention through “responsive parenting.” Responsive parenting is the ability of a parent to interpret a child’s signals and respond appropriately with warmth and support.  There are four areas of responsive parenting, including feeding, soothing, sleep, and physical activity.  Responsive feeding is the process of recognizing and responding to a child’s hunger and fullness cues.  Research shows responsive feeding is one of the key steps to preventing early childhood obesity.

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Strategies for Responsive Feeding

Here are five strategies for parents and caregivers to practice responsive feeding. Click on each strategy to watch videos and learn more.

Strategy 1. Provide a calm and comfortable place for a child to eat.

  • Hold your baby upright when feeding her a bottle or breastfeeding. 
  • Sit your young child in a high chair or secure seat facing you. 
  • Turn off all electronic devices during meal and snack times.

Strategy 2. Offer age appropriate “first foods.”

  • Provide breastmilk or iron-fortified formula as the main source of food for the first 6 months of your child’s life and continue until they are at least 1 year old.  
  • Give your child solid foods after they are 6 months old and can sit up with little or no support, maintain head and neck control, and munch and swallow.
  • If feeding your child packaged baby foods, choose ones with a single ingredient and no added sugar.

 Introducing Solid Foods

First Food Recommendations

Strategy 3. Offer food that is healthy, tasty, and provided on a schedule.

  • Aim to have regular family meals together by the time your child is 1 year old.
  • Make one meal for the entire family and offer your child the same healthy foods as the rest of the family by age 2. 
  • Provide toddlers with three meals and two to three healthy snacks at regular mealtimes each day.

Family Meals With Your Toddler

Strategy 4. Respond promptly to a child’s signs of hunger and fullness.

  • Learn your child’s hunger and fullness cues and respond accordingly.
  • Feed your child when he opens his mouth when a spoon is near, reaches for or points to spoon or food, or gets excited when food is provided.
  • Stop feeding a child when she shakes her head, turns her head away from food, or does not open her mouth.

Hunger and Fullness Cues (0-6 Months) 

Hunger and Fullness Cues (6-12 Months) 

Strategy 5: Encourage s elf-regulation.

  • Plan what your child will eat, when she will eat, and where.
  • Understand it is your child’s choice to decide whether to eat and how much. 
  • Avoid using food or other treats as a reward.

Feeding Solutions

    What We are Doing

    The Anita Zucker Center and its affiliates help translate community nutrition research for parents and practitioners to improve nutrition related programs and policies.

    Learn more:

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    Center Resources

    • Feeding Your Baby (PDF)
      Download this PDF for dietary recommendations for infants and children based on specific age ranges.
    • BabyByte (Video Series)
      This research-based video series offers age-specific tips to help parents improve responsive feeding practices with their infants and toddlers.
    1. Introduction to BabyByte

    2. Feeding from the Start (0-6 months)
    3. Introducing Solid Foods (0-6 months, 6-12 months)
    4. First Foods Recommendations (0-6 months, 6-12 months)
    5. Foods to Avoid Before Age 1 (0-6 months, 6-12 months)
    6. Feeding Milestones (6-12 months)

    7. Food Allergies (6-12 months, 12-24 months)

    8a. Picky Eating (6-12 months, 12-24 months)
    8b. Feeding Solutions
    9. Toddler Meals (12-24 months)
    10. Family Meals with Your Toddler (12-24 months)
    11. Hunger and Fullness Cues (0-6 months)
    12. Hunger and Fullness Cues (6-12 months)

    Other Resources

     

    For Families

    • 1,000 Days: For Parents
      This web resource gives parents access to informative videos on a range of topics within nutrition during the first 1,000 days of a child’s life.
    • Is Your Baby Hungry or Full? Responsive Feeding Explained
      This resource from the American Academy of Pediatrics offers video, infographics, and additional information about responsive feeding.
    • MyPlate, MyWins for Families
      This website, offered by the USDA ChooseMyPlate program, offers fun, practical tips and tools for families to help them find a healthy eating style that fits their lifestyle.

    For Practitioners

    • Feeding Guidelines for Infants and Young Toddlers: A Responsive Parenting Approach
      Download this PDF to read more about healthy eating research to prevent childhood obesity.
    • Infant Food and Feeding
      This website, by the American Academy of Pediatrics (AAP), offers information about the onset and patterns of risk behaviors associated with overweight and obesity during infancy.
    • Food & Nutrition
      Visit this website to read the Dietary Guidelines for Americans from the U.S. Department of Health and Human Services. These guidelines reflect the current body of nutrition science, helps health professionals and policymakers guide Americans to make healthy food and beverage choices, and serves as the science-based foundation for vital nutrition policies and programs across the United States.
    • Feeding Infants and Children from Birth to 24 months
      This study report from the National Academies of Science, Engineering and Medicine offers a summary of existing guidance around feeding infants and children up to two years old.

    Articles by Center Members and Collaborators

    • Heller, R. L., Chiero J. D., Puglisi, M., & Mobley, A. R. (2019). Feeding infants and toddlers: A qualitative study to determine parental education needs. Child Obesity, 15(7), 443-450. https://doi.org/10.1089/chi.2019.0024
    • Heller, R. L., & Mobley, A. R. (2019). Instruments assessing parental responsive feeding in children ages birth to 5 years: A systematic review. Appetite, 138, 23-51. https://doi.org/10.1016/j.appet.2019.03.006
    • Vollmer, R. L., Adamsons, K., & Mobley, A. R. (2019). Recruitment, engagement, and retention of fathers in nutrition education and obesity research. Journal of Nutrition Education and Behavior, 51(9), 1121-1125. https://doi.org/10.1016/j.jneb.2019.07.006
    • Musaad, S. M., Speirs, K. E., Hayes, J. T., Mobley, A. R., Fitzgerald, N., Jones, B. L., VanBrackle, A., & Sigman-Grant, M. (2017). The impact of environmental, parental and child factors on health-related behaviors among low-income children. Appetite, 112, 260-271. https://doi.org/10.1016/j.appet.2017.01.035
    • Vollmer, R. L., Adamsons, K., Foster, J. S., & Mobley, A. R. (2015). Association of fathers’ feeding practices and feeding style on preschool age children’s diet quality, eating behavior and body mass index. Appetite, 89, 274-81. https://doi.org/10.1016/j.appet.2015.02.021
    • Vollmer, R. L., & Mobley, A. R. (2013). Parenting styles, feeding styles, and their influence on childhood obesogenic behaviors and body weight: A review. Appetite, 71, 232-241. https://doi.org/10.1016/j.appet.2013.08.015

    References

    1. Birch, L. L., & Doub, A. E. (2014). Learning to eat: Birth to age 2 y. The American Journal of Clinical Nutrition, 99(3), 723S-728S. https://doi.org/10.3945/ajcn.113.069047
    2. Black, M. M., & Aboud, F. E. (2011). Responsive feeding is embedded in a theoretical framework of responsive parenting. The Journal of Nutrition, 141(3), 490-494. https://doi.org/10.3945/jn.110.129973
    3. Davison, K. K., & Birch, L. L. (2001). Childhood overweight: A contextual model and recommendations for future research. Obesity Review, 2(3), 159-171. https://doi.org/10.1046/j.1467-789x.2001.00036.x
    4. Pérez-Escamilla, R., Segura- Pérez, S., & Lott, M. (2017). Feeding guidelines for infants and young toddlers: A responsive parenting approach. Healthy Eating Research. https://healthyeatingresearch.org/research/feeding-guidelines-for-infants-and-young-toddlers-a-responsive-parenting-approach/
    5. Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999-2016. Pediatrics, 141(3), e20173459. https://doi.org/10.1542/peds.2017-3459
    6. World Health Organization. (2016, January 21). Report of the commission on ending childhood obesity. https://www.who.int/publications/i/item/9789241510066

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