Proceedings of the Nutrition Society

Reproduction and Development Group Symposium on ‘Feeding, nurture and childhood development’

The role of care in nutrition programmes: current research and a research agenda

Patrice L. Englea1 c1, Margaret Bentleya2 and Gretel Peltoa3

a1 Department of Psychology, Cal Poly State University, San Luis Obispo, CA 93405, USA

a2 Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA

a3 Department of Nutrition and Food Policy, Cornell University, Ithaca, NY 14852, USA


The importance of cultural and behavioural factors in children’s nutrition, particularly with regard to feeding, has been recognized only recently. The combination of evidence regarding the importance of caregiving behaviour for good nutrition, and improved strategies for measuring behaviour have led to a renewed interest in care. The UNICEF conceptual framework suggests that care, in addition to food security and health care services, are critical for children’s survival, growth and development. The present paper focuses on the care practice of complementary feeding, specifically behavioural factors such as parental interaction patterns, feeding style and adaptation of feeding to the child’s motor abilities (self-feeding or feeding by others). Three kinds of feeding styles (Birch & Fisher, 1995) are identified: controlling; laissez-faire; responsive. Probable effects of each feeding style on nutrient intake are described. A number of studies of feeding behaviour have suggested that the laissez-faire style is most frequently observed among families and communities with a higher prevalence of malnourished children. Nutrition interventions that have been able to show significant effects on outcomes, such as the Hearth Model in Vietnam (Sternin et al. 1997), have usually incorporated behavioural components in their intervention. At this time, there have been no tests of the efficacy of behavioural interventions to improve feeding practices. Research is needed to understand behavioural factors in complementary feeding, and to identify and test intervention strategies designed to improve nutrient intake of young children. Finally, the paper concludes with a discussion of how nutrition programmes might change if care were incorporated.


c1 *Corresponding author: Professor Patrice L. Engle, fax +1 805 756 1134, email