Parental anxiety/depression linked to pre-schoolers' fussy eating

Parental anxiety and/or depression during pregnancy and before their child starts school is linked to a heightened risk of that child becoming a 'fussy' eater, finds research published online in the Archives of Disease in Childhood.

The associations were evident for mums at both time periods, but just during the pre-school period for dads, the findings indicate.

Fussy eating behaviour, which is characterised by the consistent rejection of particular foods, is common in childhood, and a frequent source of concern for parents, say the researchers.

It has been associated with constipation, weight problems and behavioural issues in the child. And it's been linked to postnatal anxiety and depression in mums.

But it's not been clear if this anxiety/depression is caused by the child's eating patterns or is itself a risk factor, nor is it known what potential impact the dad's state of mind might have.

In a bid to try and answer these questions, the researchers quizzed participants in the Generation R study, which has been tracking the health and wellbeing of children from pregnancy onwards since 2002 in The Netherlands.

The current analysis was based on 4746 mother and child pairs and 4144 dads, whose children had all been born between 2002 and 2006.

Parents were asked to complete a validated questionnaire (BSI) during mid pregnancy, and then again three years later, to assess their own symptoms of anxiety and depression. And mothers completed another validated questionnaire (CEBQ) on childhood eating patterns, when their child reached the age of 4. Fathers also filled in a few questions about their child's eating patterns when s/he was 3 years old.

By the age of 3, around 30% of the children were classified as fussy eaters.

After taking account of influential factors, such as educational attainment and household income, maternal anxiety during pregnancy, and during the preschool period, were both independently associated with fussy eating behaviour by the time their child was 4 years old. This was irrespective of their own symptoms when the child was 3.

Each additional point the mums scored on the anxiety scale in pregnancy was associated with an extra point on the score denoting fussy eating in their child.

Among the dads, only anxiety during the preschool period was associated with fussy eating in their child.

Further analysis showed that not only were clinically high maternal anxiety scores associated with fussy eating, but also scores that were above average, compared with mums who scored average or below average.

As for depression, higher maternal scores during the antenatal period as well as three years after the birth were independently related to higher fussy eating scores among their 4 year olds. The results were similar for the dads.

This is an observational study so no firm conclusions can be drawn about cause and effect, but the findings back up those of other research, say the study authors.

And the finding that the mum's antenatal symptoms predicted a 4 year old's fussy eating behaviour, irrespective of whether she had symptoms when the child was 3, "strongly suggests that the direction of the associations with mothers' antenatal symptoms is from mother to child," they write.

"Clinicians should be aware that not only severe anxiety and depression, but also milder forms of internalising problems can affect child eating behaviour," they add.