Maternal feeding practices and fussy eating in toddlerhood: A discordant twin analysis

Holly A. Harris, Alison Fildes, Kimberley M. Mallan, Clare H. Llewellyn*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

59 Citations (Scopus)


Background: Parental feeding practices are thought to play a causal role in shaping a child's fussiness; however, a child-responsive model suggests that feeding practices may develop in response to a child's emerging appetitive characteristics. We used a novel twin study design to test the hypothesis that mothers vary their feeding practices for twin children who differ in their 'food fussiness', in support of a child-responsive model. Methods: Participants were mothers and their 16 month old twin children (n=2026) from Gemini, a British twin birth cohort of children born in 2007. Standardized psychometric measures of maternal 'pressure to eat', 'restriction' and 'instrumental feeding', as well as child 'food fussiness', were completed by mothers. Within-family analyses examined if twin-pair differences in 'food fussiness' were associated with differences in feeding practices using linear regression models. In a subset of twins (n=247 pairs) who were the most discordant (highest quartile) on 'food fussiness' (difference score≥.50), Paired Samples T-test were used to explore the magnitude of differences in feeding practices between twins. Between-family analyses used Complex Samples General Linear Models to examine associations between feeding practices and 'food fussiness'. Results: Within-pair differences in 'food fussiness' were associated with differential 'pressure to eat' and 'instrumental feeding' (ps<.001), but not with 'restriction'. In the subset of twins most discordant on 'food fussiness', mothers used more pressure (p<.001) and food rewards (p<.05) with the fussier twin. Between-family analyses indicated that 'pressure to eat' and 'instrumental feeding' were positively associated with 'food fussiness', while 'restriction' was negatively associated with 'food fussiness' (ps<.001). Conclusions: Mothers appear to subtly adjust their feeding practices according to their perceptions of their toddler's emerging fussy eating behavior. Specifically, the fussier toddler is pressured more than their less fussy co-twin, and is more likely to be offered food rewards. Guiding parents on how to respond to fussy eating may be an important aspect of promoting feeding practices that encourage food acceptance.

Original languageEnglish
Article number81
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Issue number1
Publication statusPublished - 13 Jul 2016
Externally publishedYes

Bibliographical note

Funding Information:
We would to thank the Gemini families participating in the study and the Office of National Statistics for assistance in recruiting the families. Gemini was funded by a grant from Cancer Research UK (C1418/A7974) and was led by Professor Jane Wardle (Project Investigator). We wish to acknowledge Professor Jane Wardle who provided input in the study conceptualization. Holly Harris is funded by an Australian Postgraduate Award and Endeavour Postgraduate Scholarship.

Publisher Copyright:
© 2016 The Author(s).


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