Objective To describe caregivers’ pressure-to-eat feeding practices and its three sub-categorical behaviors, which are continue feeding at refusals, trying to feed more, and full but still feeding, on infants and toddlers aged 6 to 24 months, and to analyze the differences in practices across different general characteristics of caregivers, infants and toddlers. This study would provide comprehensive understanding and evaluation of pressure-to-eat feeding practices, and serve as a reference in the promotion of optimal feeding practice.

Methods A total of 20 pairs of healthy infant-caregivers participated in this study. Videos were recorded during children’s main meals within a normal day by camera. Pressure-to-eat feeding practice and its three sub-categorical behaviors were extracted, coded, and categorized. General characteristics of caregivers, infants and toddlers were collected through questionnaire. The distribution of pressure-to-eat feeding practice and its three sub-categorical behaviors was described. Fisher’s test, independent sample t test, and Wilcoxon rank sum test were used to examine the differences of pressure-to-eat feeding and its three sub-categorical behaviors across different general characteristics of caregivers, infants and toddlers.

Results Eighteen participants (90.00%) had used pressure-to-eat feeding practices. The median times of the caregivers used pressure-to-eat feeding practices was 2.50 per meal. The median total duration of pressure-to-eat feeding was 31.17 seconds per meal. The median average duration of pressure-to-eat feeding was 13.50 seconds. Caregivers were most likely to use pressure-to-eat feeding during breakfast, with the highest frequency. The occurrence probability and frequency of the three sub-categorical behaviors, from high to low, are as follows: continue feeding at refusals, trying to feed more, and full but still feeding. The presence of pressure to eat was associated with caregivers’ age (P = 0.01), BMI (P = 0.03), and child’s order (P = 0.02). The number of pressure-to-eat was related to mother’s education (P = 0.03). Trying to feed more was related to father’s age (P = 0.03). Whether to continue feeding at refusals (P < 0.05) and the number of its times (P = 0.03) were related to children’s age.

Conclusion The pressure-to-eat feeding practice appear to be a common but inappropriate feeding practice, which is associated with general characteristics of caregivers, infants and toddlers. It is necessary to enhance caregiver’s knowledge of optimal feeding practices in order to promote their appropriate feeding behaviors.