"A few more bites?": Manifestation of pressure-to-eat in child care.

Pressuring children to eat can override hunger and satiety cues, which may lead to over- or under-eating and food refusal. This study aims to describe the manifestations of pressure-to-eat in child care from early childhood educators. A secondary data analysis was conducted using qualitative content analysis. Observations of educators from child care centres in Nova Scotia and Prince Edward Island (n = 9) occurred over 2 days. Observation data were coded and counted to determine the most and least prevalent forms of pressure. The count results were then assessed quantitatively by educator demographic characteristics to explore potential associations using nonparametric tests (Mann-Whitney U test, Spearman's correlations). Offering food and encouraging eating without referencing hunger or satiety was found to be the most common type of pressure; serving children without asking if they were hungry made up the majority of this type of pressure. This was less common with both increasing educator age (r = -0.692, p = 0.039), as well as years of experience (r = 0.878, p = 0.002). Pressuring children to eat by referring to health benefits and consequences was the least common type of pressure. This study provides insight into the types and frequency of pressure-to-eat strategies implemented in child care centres, which can inform interventions to create more responsive feeding environments.