Association between caregivers’ anxiety and depression symptoms and feeding difficulties of preschool children: A cross-sectional study in rural China

To investigate the prevalence of feeding difficulties in preschool children and explore the association between caregivers’ anxiety and depression symptoms and preschool children's feeding difficulties. This cross-sectional study was conducted between June 2017 and January 2018 in rural areas of Anhui province, China. A total of 2231 preschool children and their caregivers were interviewed. Feeding difficulties of preschool children were reported by caregivers using the adapted Identification and Management of Feeding Difficulties (IMFeD) tool. Anxiety and depression symptoms of caregivers were evaluated via the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). In total, 54.1% of preschool children were reported to have feeding difficulties by their caregivers. Among all children, when the caregivers had symptoms of anxiety or depression, the children had a higher risk of feeding difficulties. Specifically, for caregivers’ anxiety symptoms, the odds ratios (ORs) of feeding difficulties in all children, left-behind children (LBC), and non-LBC were 1.91 (95% confidence interval [CI]: 1.42–2.57), 2.04 (95% CI: 1.34–3.09), and 1.86 (95% CI: 1.21–2.87), respectively; for caregivers’ depression symptoms, the ORs of feeding difficulties in all children, LBC, and non-LBC were 1.86 (95% CI: 1.46–2.39), 1.76 (95% CI: 1.24–2.51), and 2.08 (95% CI: 1.45–2.97), respectively. In addition, when caregivers who were parents or grandparents had anxiety or depression symptoms, their children had a higher risk of feeding difficulties. Specifically, for parents and grandparents with anxiety symptoms, the ORs of feeding difficulties were 1.84 (95% CI: 1.14–2.98) and 2.17 (95% CI: 1.46–3.22), respectively; for parents and grandparents with depression symptoms, the ORs of feeding difficulties were 2.03 (95% CI: 1.40–2.95) and 1.93 (95% CI: 1.37–2.73), respectively. Caregivers’ anxiety or depression symptoms are positively associated with feeding difficulties in children.