Pathways between maternal depression, the family environment, and child BMI z scores

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Purpose: Modifiable aspects of the family environment that contribute to overweight in younger children have been identified, including parental feeding practices, child eating behaviors, and parenting practices related to eating and household routines. Maternal depression influences many of these factors, yet research examining pathways that may link maternal depression through the family environment to child weight is lacking. The current study examined parental feeding practices, child eating behaviors, and eating and household routines as potential mediators between maternal depressive symptoms and child weight at age six. The study also tested for differential effects of early versus concurrent maternal depressive symptoms. Methods: Longitudinal data on 1130 mothers and their children who participated in the Infant Feeding Practices Study II (IFSP II) and its Year 6 Follow-Up study were analyzed. A multi-step, multiple mediator model assessed direct and indirect relationships between early depressive symptoms (two months post-partum) and concurrent depressive symptoms with child Body Mass Index (BMI) z scores at age six. Potential mediators included parental feeding practices, child eating behaviors, and eating and household routines. Results: Higher early depressive symptoms directly explained lower child BMI z scores. Early depression also worked through concurrent depression, the child's food responsiveness, and the hours the child slept on week nights to explain higher child BMI z scores. Parental efforts to make sure the child eats enough directly predicted lower child weight but did not mediate the effects of early or concurrent maternal depressive symptoms. Conclusions: The findings suggest the need for greater attention to the relationships between maternal depression and child weight as a critical step toward developing effective obesity prevention strategies.

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