Higher weight status of only and last-born children. Maternal feeding and child eating behaviors as underlying processes among 4-8 year olds

Appetite. 2015 Sep;92:167-72. doi: 10.1016/j.appet.2015.05.021. Epub 2015 May 22.


Birth order has been associated with childhood obesity. The objective of this cross-sectional study was to examine maternal feeding and child eating behaviors as underlying processes for increased weight status of only children and youngest siblings. Participants included 274 low-income 4-8 year old children and their mothers. The dyads completed a videotaped laboratory mealtime observation. Mothers completed the Caregiver's Feeding Styles Questionnaire and the Children's Eating Behavior Questionnaire. Child weight and height were measured using standardized procedures. Path analysis was used to examine associations of birth order, maternal feeding behavior, child eating behavior, and child overweight/obese status. The association between only child status and greater likelihood of overweight/obesity was fully mediated by higher maternal Verbal Discouragement to eat and lower maternal Praise (all p values < 0.05). The association between youngest sibling status and greater likelihood of overweight/obesity was partially mediated by lower maternal Praise and lower child Food Fussiness (all p values < 0.05). Results provide support for our hypothesis that maternal control and support and child food acceptance are underlying pathways for the association between birth order and weight status. Future findings can help inform family-based programs by guiding family counseling and tailoring of recommendations for family mealtime interactions.

Keywords: Birth order; Eating behavior; Feeding behavior; Obesity; Overweight.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Birth Order*
  • Body Mass Index
  • Child
  • Child Behavior
  • Child Nutritional Physiological Phenomena*
  • Child, Preschool
  • Cohort Studies
  • Cross-Sectional Studies
  • Early Intervention, Educational
  • Feeding Behavior*
  • Feeding Methods*
  • Female
  • Humans
  • Male
  • Maternal Behavior*
  • Michigan / epidemiology
  • Mothers
  • Only Child*
  • Overweight / epidemiology
  • Overweight / etiology
  • Overweight / prevention & control
  • Pediatric Obesity / epidemiology
  • Pediatric Obesity / etiology*
  • Pediatric Obesity / prevention & control
  • Prevalence
  • Risk