Bidirectional Associations between Parental Non-Responsive Feeding Practices and Child Eating Behaviors: A Systematic Review and Meta-Analysis of Longitudinal Prospective Studies

Background: Parental non-responsive feeding practices and child eating behaviors both play significant roles in childhood obesity. However, their longitudinal relationships are less clear. This systematic review aimed to examine their bidirectional associations. Methods: A systematic search of five databases was conducted from inception to February 2022. Data synthesis was performed using a semi-quantitative and quantitative approach. Results: A total of 14 studies with 15348 respondents were included. A total of 94 longitudinal effects from 14 studies of parental non-responsive feeding practices on child eating behaviors were investigated, and 19 statistically significant effects were discovered. Seventy-seven longitudinal effects from nine studies of child eating behaviors on parental feeding practices were examined, with fifteen being statistically significant. The pooled results of meta-analysis showed five statistically significant associations: parental restrictive feeding positively predicted child enjoyment of food (beta = 0.044; 95% CI: 0.004, 0.085); use of food as a reward positively predicted child emotional eating (beta = 0.09; 95% CI: 0.04, 0.15); child food responsiveness positively predicted restrictive feeding (beta = 0.04; 95% CI: 0.02, 0.06); use food as a reward (beta = 0.06; 95% CI: 0.03, 0.10). In addition, the pooled effects showed that child satiety responsiveness negatively predicted restrictive feeding (beta = -0.05; 95% CI: -0.08, -0.01). Conclusions: The bidirectional relationships between parental non-responsive feeding practices and child eating behaviors are inconsistent and a few showed statistical significance. Theory-driven longitudinal studies using validated instruments and controlling for potential confounders are needed to unveil their relationships and provide evidence for obesity prevention interventions.