Feeding practices and concerns as mediators between maternal mental health and eating behaviours in early childhood

Background: The impact of maternal mental health on child eating beyond infancy is understudied. This study explores whether maternal feeding practices and concerns mediate the association between maternal depression and anxiety symptoms and eating behaviours at age three years. Methods: Data from 409 mother-child dyads in the Growing Up in Singapore Towards healthy Outcomes cohort were analysed. Maternal mental health was assessed using the Beck Depression Inventory-II and State-Trait Anxiety Inventory, feeding practices and concerns with the Preschooler Feeding Questionnaire, and child eating behaviours with the Children's Eating Behaviour Questionnaire. Structural equation modelling was used to test pathways. Results: Depression symptoms in mothers showed direct and indirect links to child eating behaviours. For example, maternal depression symptoms were directly associated with enjoyment of food (B = 0.011, p = 0.015) and indirectly with food responsiveness (B = 0.004, p = 0.034) via use of food to calm the child. Anxiety symptoms, however, had only indirect associations with child eating behaviours through maternal feeding concerns, not practices. For example, maternal anxiety symptoms were indirectly linked with food responsiveness through perceived difficulty in feeding (B = −0.001, p = 0.011). Conclusions: Depression and anxiety symptoms influence children's eating behaviours differently. Anxiety symptoms were linked with child eating behaviours only through maternal feeding concerns, whereas depression symptoms were linked with child eating behaviours both directly and indirectly via feeding to calm the child. As maternal anxiety symptoms are linked with more child eating concerns, the validity of mother-reported child eating behaviours requires consideration.