Parent and child mealtime behavior in families of children with cystic fibrosis

Objectives: We investigated the hypothesis thai children with cystic fibros is (CF) and their parents would show more maladaptive behaviors during dinn er than children without CF and their parents. Study design: Children with CF (n = 32) and their parents were compared wit h 29 children without CF and their parents on the rate and frequency of par ent-child behaviors during a typical dinner in the families' homes by using multivariate analyses of variance. Results: When the rate of behavior controlling for meal length, was examine d, no differences were found between groups. However, parents of children w ith CF were found to differ from parents of control subjects in the frequen cy of direct and indirect commands (P<.05), coaxes (P<.01), physical prompt s (P<.01), and feeding their child (P<.05). Children with CF were found to engage in more talk, spend more time away from the table, refuse food, and exhibit more noncompliance toward commands to eat than control children (P< .05 for all child variables). When behaviors were examined as a function of meal phase, parents of children with and without CF both showed an increas e in commands (P<.01), coaxes (P<.05), feeds (P<.01), and physical prompts (P<.01) in the second half of the meal as compared with the first. Children with CF and the control children showed an increase in behaviors incompati ble with eating during the second half of the meal compared tv;th the first (P<.01). When faster eaters were compared with slower eaters, faster eater s consumed a higher percentage of the recommended daily allowance of energy (P<.01) than slower eaters and showed a trend to be at higher weight perce ntiles for age and sex (P=.08) regardless of group (CF or control). Conclusions: Children with CF and their parents do not differ from children without CF and their parents in the rate of behaviors exhibited or types o f strategies used to encourage:eating. However, children with CF and their parents engage in these behaviors more frequently. Our data do not support typical parenting behaviors as effective in meeting the CF dietary requirem ents. Additional support in the form of child behavior management training may be needed to assist parents in meeting their child's caloric requiremen ts.