“A few more bites?”: Manifestation of pressure‐to‐eat in child care

Abstract

Aims

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.

Methods

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).

Results

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.

Conclusion

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.

1. INTRODUCTION

In Canada, approximately half of all children attend child care programs during their childhood, spending significant time there weekly. ¹ Early childhood educators play a pivotal role in fostering children's growth, including healthy relationships with food and feeding. ² , ³ While children are born with the ability to recognise hunger and satiety cues, caregivers must support this ability for autonomy and competence to be sustained. ² , ⁴ , ⁵ , ⁶ , ⁷ Responsive feeding environments, characterised by emotionally supportive and developmentally appropriate caregiver behaviours, enhance children's interest in feeding, awareness of hunger and satiety cues, and communication of their feeding‐related needs. ⁴ , ⁷ Conversely, less responsive feeding environments may disregard these cues, leading to stressful eating environments and to potential health and wellbeing issues. ⁴ , ⁷

Non‐responsive feeding practices include instrumental, restrictive, and pressure‐related feeding. ⁸ This study focuses on pressure‐to‐eat, which involves verbal or physical cues to control food intake. ⁵ , ⁸ Although often well‐intentioned, ³ , ⁹ such pressure can override children's innate ability to self‐regulate, potentially harming their relationship with food and increasing the risk of disordered eating later in life. ⁴ , ⁵ Common forms of pressure‐to‐eat include verbal prompts, praise, explanations of health benefits, restrictions on desired foods or activities until a specific food is eaten, and subtle cues like asking if a child wants more food without referencing their hunger or satiety. ⁵ , ⁷ Studies suggest that caregivers often implement pressure‐to‐eat with good intentions in response to concerns that the child might be hungry or health concerns related to perceived weight status ⁴ , ⁶ , ¹⁰ , ¹¹ but they lack understanding of the potential short and long‐term negative impacts on nutrition and health. ³ , ⁶ These practices have often been described in the literature among parents ⁴ , ¹⁰ , ¹¹ and there is also increasing recognition of the presence of pressure‐to‐eat practices among early childhood educators working in child care programs. ³ , ⁶ However, there is limited characterisation and quantification of the specific forms of pressure‐to‐eat which could help to inform future interventions. This study aimed to identify the forms of communication and actions educators use to pressure children to eat and how frequently these occur.

2. METHODS

This study utilised secondary data from the Coaching in Early Learning Environments to Build a Responsive Approach to Eating (CELEBRATE) Feeding feasibility project, where Early Years Nutrition Coaches worked with nine child care centres in Nova Scotia (n = 5) and Prince Edward Island (n = 4) to support responsive feeding environments using The Behaviour Change Wheel. ¹² Baseline assessments included an adapted version of the Environment and Policy Assessment and Observation tool, which included collection of both quantitative and qualitative information on the child care feeding environment. ¹³ , ¹⁴ This study used a convergent mixed methods design ¹⁵ through a directed content analysis ¹⁶ , ¹⁷ of the qualitative raw observation notes and quantitative demographic information to explore differences in pressure across educators.

The research, conducted in the Canadian Maritime region (an important location to study food‐related behaviours given its rurality, smaller population sizes, and high rates of chronic disease and food insecurity relative to the rest of the country), ¹⁸ , ¹⁹ , ²⁰ involved purposive selection of centres following a public call for participation. Centres represented diverse sizes and demographics. Ethical approval was granted by the Prince Edward Island and Mount Saint Vincent University's Research Ethics Boards. Written consent was obtained from educators, directors, and parents of children before observations began.

Two trained researchers conducted full‐day observations of consenting educators in two classrooms per centre and participating educators provided demographic information collected through an optional online survey. One classroom was observed per day, beginning before the morning snack and finishing following the afternoon snack. Observers wrote notes by hand, considering elements of the modified Environment and Policy Assessment and Observation tool ¹³ and using an anecdotal record approach ²¹ to understand the running account of food and feeding conversations and interactions throughout the day (including during playtime). Observers staggered their classroom placement to ensure data were collected from all areas of the classroom during observations. After each observation, the observers independently reviewed and typed their notes, and they were merged for clarity and richness, with duplicate observations combined.

The directed content analysis aimed to gain insight into the manifestation of pressure‐to‐eat in child care centres while validating and/or extending pre‐existing literature. ¹⁶ , ¹⁷ A constructivist paradigm informed the content analysis approach as it illuminates the contextual meaning of the text by analysing language characteristics and classifying it into distinct but related categories. ¹⁶ , ¹⁷ This method allowed pre‐existing literature ⁶ , ⁷ , ²² , ²³ , ²⁴ to develop four overarching types of pressure‐to‐eat categories for coding, including: offering and encouraging eating without referencing hunger or satiety, referring to health benefits and consequences, encouraging children to try foods, and offering praise (see Table 1).

TABLE 1.

Constructs of pressure explored in this study.

Type of pressure	Rationale based on previous literature
Offering praise	Children may ignore their internal cues in favour of pleasing their educator 6
Encouraging children to try foods (e.g., asking children to take one bite)	Statements can be conveyed as formal commands, creating an expectation for the child 48 , 49
Referring to health benefits and consequences	Children may ignore their feeling of fullness to eat foods labelled as promoting growth and health by their educator 7 , 48
Offering and encouraging eating without referencing hunger or satiety	Hinders development of autonomy and competence by removing the opportunity for the child to learn how to listen to their own internal cues 7 , 8

Data were analysed through coding using MAXQDA 2022. Several phases took place, including familiarisation with the data, the development of initial code labels and codes, and post‐coding analysis to determine the most common type(s) of pressure‐to‐eat in the participating centres. ¹⁶ , ¹⁷ Each code was sorted into one of four overarching types where forms of pressure with similar intents were grouped together. Occasionally, the pressure fit into multiple codes and were coded in each applicable location, known as simultaneous coding. Saldaña ²⁵ suggests that simultaneous coding should be used sparingly but is suitable when the data indicates multiple meanings that warrant the use of more than one code. ²⁶

A detailed explanation of the analysis is shown in Table 2. The analysis was completed by the lead author, a dietetic intern student who also conducted some of the centre observations throughout the project. To ensure agreement on interpretations and trustworthiness, the codes and definitions, as well as analyses and findings were reviewed with other members of the larger author group of experienced researchers (all women) who have expertise in dietetics, nutrition, and early childhood education. The reporting of our qualitative methods were compliant with the SRQR guidelines. ²⁷

TABLE 2.

Phases of directed content analysis and associated actions. ¹⁶ , ¹⁷

Phase	Action
Data preparation and organisation	Data were prepared and organised for analysis by the CELEBRATE Feeding researchers. Each day of observation had a document with the centre's final scores and notes in the anecdotal record. For the secondary analysis, data were uploaded to qualitative data analysis software (MAXQDA 2022) and sorted into files by province and centre
Initial immersion and data familiarisation	Data were reviewed one observation at a time. The data from each centre were read and re‐read so initial ideas about what was collected could be formed. Further, potential patterns were identified. While going through the data, notes were made about thoughts and questions
Coding/code generation	Before actively coding, a code book was generated to describe and provide examples of what types of data fell under each code label. A preliminary code book was created based on the literature. Code labels were refined as required. During the initial code generation, the data were meaningfully labelled and organised so codes matched with appropriate code labels
Post‐coding	The code labels were sorted into broader subtypes with several code labels that represented one overall type of pressure. Then, the number of codes per subtype were determined and the most prevalent forms of pressure‐to‐eat were identified using counts and proportions

The count results of pressure subtypes were quantitatively analysed using nonparametric tests (Mann–Whitney U test, Spearman's correlations) to explore difference between provinces and associations with centre‐level average educator demographic data. Because the pressure count data were collected per centre, the average values of all educators who provided demographic data in the pre‐intervention survey per centre were calculated and used in the correlations. Given that individual level data were unavailable by count, categorical demographics could not be compared. The analysis was conducted in SPSS v. 28 (IBM Corp, Armonk, NY).

3. RESULTS

Sixty educators were observed in total. The demographic characteristics of participating educators who also completed the demographic survey (n = 34, 56.7%) are shown in Table 3. An average of 6.7 educators were observed per centre (ranging from 3 to 11) and an average of 3.3 educators per centre had demographic data included in the centre average values, ranging from 1 to 6. The majority of educators (94.1%) identified as women. The ages ranged, with the majority less than 25 years old (30.3%). The reported mean length of time working as an early childhood educator was 10.3 years, with the majority (35.3%) having been in the field between 2 and 9 years. About half (51.6%) of the participants had an early childhood education college diploma. European descent was the most prevalent educator ethnicity (44.1%).

TABLE 3.

Demographics of observed educators in participating centres.

Demographic	Responses
Number of observed educators with demographic data per centre	N = 34, mean (SD) 3.8 (1.6), range (1–6)
Gender	N = 34, n (%)
Man	1 (2.9)
Woman	32 (94.1)
Prefer not to answer	1 (2.9)
Age	N = 33, n (%)
<25 years	10 (30.3)
26–35 years	7 (21.2)
36–45 years	9 (27.3)
>46 years	7 (21.2)
Years as an ECE	N = 34, n (%)
<2 years	8 (23.5)
2–9 years	12 (35.3)
10–20 years	8 (23.5)
>20 years	6 (17.6)
ECE level	N = 32, n (%)
None	1 (3.2)
Some coursework (i.e., level one certification)	5 (16.1)
ECE college certificate	3 (9.7)
ECE college diploma	19 (51.6)
Bachelor's degree or beyond	4 (12.9)
Ethnic/cultural background	N = 34, n (%)
Acadian	4 (11.8)
Asian	6 (17.6)
European	15 (44.1)
Other	5 (14.7)
Prefer not to answer	4 (11.8)
Parent	N = 30, n (%)
Yes	18 (60.0)
No	12 (40.0)

Abbreviation: ECE, early childhood education.

After coding the raw notes from the anecdotal records from 2 days of observation in each of the 18 classrooms, the use of different forms of pressure‐to‐eat was identified a total of 523 times. Table 4 provides examples of phrases and actions employed by educators during mealtimes and their organisation into 14 codes based on the literature, the frequency of each pressure type, and the overall total of pressure incidences per centre. Offering and encouraging eating without reference to hunger or satiety was the type of pressure used most frequently (n = 182). This was closely followed by the encouragement to try foods (n = 174).

TABLE 4.

Frequency of each type and subtype of pressure and examples of the verbal communication and physical actions implemented by educators.

Types and subtypes of pressure	Centre
	1	2	3	4	5	6	7	8	9	Subtype total	Type total
Offering praise
Other child focus	0	0	0	0	6	3	0	0	0	10
“Wow! Look at [child]! Good job, good boy!”
Educator focus	0	3	1	3	0	0	1	0	5	13	95
“I am so proud you're eating your fruit”
Direct praise	3	9	3	0	7	3	2	4	41	72
“Eating your crust? Good job!”
Encouragement to try food
One bite	0	0	0	0	2	0	1	0	7	10
“Did you try it? Show me one bite”
“Show me how you take a big bite of everything”
Referring to foods being good/liked	12	10	9	20	10	7	6	3	15	92	174
“Eat your fruit too, it's really yummy”
“It's ok but I think you are missing out because it's really good”
Try foods	1	3	7	1	18	10	2	3	27	72
“I want you to try something out of your bowl”
“Really? You don't want to try it? Just try it, one piece”
Referring to health benefits/consequences
Health consequences	1	0	0	0	1	0	0	1	6	9
“You have to eat. It's why you keep getting headaches because you don't eat during the day”
Health benefits	2	0	1	1	1	0	0	0	10	15	72
“Milk makes your bones strong, helps them grow, and your teeth”
“Your muscles are going to grow big and strong”
Consume a specific food	4	2	4	7	17	1	1	1	11	48
An educator asks a child to eat their pineapple before serving more crackers
“You need to eat some soup”
Offering and encouraging eating without referencing hunger or satiety
Eat in order to…	0	1	2	2	1	1	0	0	2	9
“Once you finish your snack you can go outside quicker. Finish what you still have”
Eat more	5	6	3	1	14	4	5	1	10	49
“Let's see if we can get a few more bites”
Eat all foods	10	1	4	10	2	2	2	2	12	45	182
“You have to eat the rest of it first”
“You eat it all, I know you can do it”
Serving without asking	5	0	5	11	13	8	5	0	3	50
Educator serves seconds to children without asking if they want more or if they are hungry/full
The educator tries to spoon food into a child's mouth twice, and the child pushes away both times
Repeated offerings	1	1	3	0	4	1	5	5	9	29
An educator continues to offer food to a child who does not want food. Child eventually begins eating
Centre total	44	36	42	57	96	40	30	20	158	523	523

The frequencies ranged between each subtype, as was shown in Table 4. Figure 1, however, illustrates the proportion of each subtype within its overall type, demonstrating which subtypes of pressure were most and least common. Serving without asking was the most abundant (n = 50), along with eat more (n = 49) in the offering and encouraging eating without reference to hunger or satiety type. Within, encouragement to try food, referring to foods being good/liked was used most frequently (n = 92). Offering praise was the third most frequently used type of pressure, where direct praise made up its bulk (n = 72). Finally, referring to health benefits and consequences was the least used. When implemented, educators prompted children to consume a specific food (n = 48) more often than they made direct statements about health benefits or consequences.

FIGURE 1.

Relative proportions of the subtypes comprising each type of pressure across all centres.

Among each type, some subtypes of pressure were not used as often. Subtypes used less frequently included: offering praise by focusing on other children, encouragement to try foods by requiring children to take one bite, referring to health consequences, and telling children that they must eat in order to do another activity.

When assessing how province related to pressure subtype count data, the Mann–Whitney U test indicated that there was only one significant difference, such that Nova Scotia centres (median = 5, IQR = 1) had a higher instance of offering and encouraging food through repeated offerings than Prince Edward Island centres (median = 1, IQR = 0.75); U = 2.00, z = −2.00, p = 0.045. The correlations between each centre's average educators' ages, years as an educator, and education levels are presented in Table 5 and revealed several significant findings. Among the offering praise pressure type, there were no significant correlations between any of the educator demographic variables. Within encouragement to try foods pressure types, there was a significant moderate, inverse correlation between encouragement to try one bite and average years of early childhood education experience (r = −0.683, p = 0.042) and higher education level had a strong positive correlation with referring to foods being good or liked (r = 0.727, p = 0.027). For the types of pressure that refer to health consequences and benefits, higher age was strongly inversely correlated with the use of pressure related to health consequences (r = −0.767, p = 0.016). On the other hand, a strong positive correlation existed between education level and encouraging children to consume specific foods (r = 0.713, p = 0.031). Last, within offering and encouraging eating without referencing hunger or satiety pressure types, encouraging children to eat more was strongly and inversely correlated with more years of early childhood education experience (r = −0.840, p = 0.005).

TABLE 5.

Correlations between average centre demographics and pressure subtypes.

Pressure types and subtypes	Average age		Average years ECE		Average education level
	Correlation coefficient (r)	p‐value	Correlation coefficient (r)	p‐value	Correlation coefficient (r)	p‐value
Offering praise
Other child focus	−0.378	0.316	−0.548	0.127	0.210	0.588
Educator focus	0.419	0.262	0.255	0.508	0.166	0.669
Direct praise	−0.545	0.129	−0.525	0.146	−0.147	0.706
Encouragement to try foods
One bite	−0.358	0.344	−0.683 a	0.042	−0.106	0.786
Referring to foods being good/liked	−0.122	0.755	−0.126	0.748	0.727 a	0.027
Try foods	−0.354	0.349	−0.529	0.143	−0.155	0.691
Referring to health benefits/consequences
Health benefits	−0.401	0.285	−0.355	0.349	0.430	0.248
Health consequences	−0.767 a	0.016	−0.634	0.067	−0.171	0.659
Consume a specific food	−0.239	0.535	−0.349	0.357	0.713 a	0.031
Offering and encouraging eating without referencing hunger or satiety
Eat in order to	0.344	0.365	0.211	0.586	0.511	0.159
Eat more	−0.599	0.088	−0.840 b	0.005	0.137	0.725
Eat all foods	−0.154	0.693	−0.061	0.876	0.210	0.588
Serving without asking	0.026	0.948	−0.179	0.645	0.600	0.088
Repeated offerings	−0.265	0.491	−0.392	0.297	−0.652	0.057

Abbreviation: ECE, early childhood education.

^a Significant correlations at the (p < 0.05) level.

^b Significant correlations at the (p < 0.01) level.

4. DISCUSSION

This was a descriptive study aimed at investigating how educators exert pressure on children to eat in child care feeding environments through language and actions. It was found that two overarching types of pressure were commonly implemented by educators—pressuring children to try foods and not referencing hunger or satiety during mealtime. The most common subtypes of pressure used were referring to foods being good or liked, getting children to try the food, and direct praise for eating. In contrast, the least used type of pressure was referring to health benefits and consequences, and the least common subtypes of pressure‐to‐eat were enforcing children to take one bite, stating health consequences, offering praise focused on other children, and requiring children to eat in order to do another activity. The use of pressure varied among centres, with some employing certain types more or less frequently than others. This variation may reflect differences in educators' beliefs, upbringing, or environment, or it may reflect the general philosophy of the centres, which are often guided by the application of provincial nutrition standards and early childhood curriculum frameworks. For example, in the provinces where this study was conducted, responsive feeding is included as part of the nutrition standards, ²⁸ , ²⁹ but it is not typically monitored for implementation.

The examples of pressure used by educators in our results highlight what Ramsay et al. ⁷ explored concerning the use of internal comments (which cue feelings of hunger and satiety) versus non‐internal comments during mealtimes. The absence of references to hunger or fullness is a clear example of a non‐internal comment. Similarly, instructing children to try, eat, or finish their food represents another form of non‐internal comment, as it directs behaviour without encouraging children to listen to their internal cues. Table 4 showed how educators tended to use direct comments and auxiliary verbs, making statements such as “you need to eat some soup,” “you have to eat the rest first,” or “eat your fruit.” The limited use of internal comments and the construction of the statements used during mealtime appears to support the initial idea that educators may not understand or believe that children have the innate ability to recognise hunger and satiety cues. ⁶ , ²² Pressure‐to‐eat may also stem from fearing children will not consume enough nutrients unless they are prompted to eat an arbitrary amount of food deemed adequate, particularly with selective eaters. ³⁰ These concerns reflect Concern‐Based Control Beliefs, the idea that adults know best when, what, and how much children should eat. ²³ This may suggest that the pressure imposed by educators is unintentional or unconscious, which is likely to make a change such as implementing and using responsive feeding practices more difficult since these methods may be deeply ingrained into one's beliefs and behaviours.

The reported demographics (Table 3) and their correlations with pressure‐to‐eat behaviours (Table 5) highlighted how educators' characteristics could impact the use of pressure in child care feeding environments. Although this research cannot causally determine what caused the use of pressure‐to‐eat, it is important to recognise that the different demographics of the participating educators likely played a role. The ages and years of experience of the educators may have had an impact. In this study, centres with older and more experienced educators were found to be less likely to use certain forms of pressure such as encouraging to take one bite, referring to health consequences, or encouraging children to eat more than they naturally are, as indicated by negative correlations. This finding was in line with a study of rural parents, where older parental age was significantly related to fewer inappropriate feeding practices such as “trying to get your child to eat something at a meal when the child says, ‘I'm not hungry.’” ³¹ This might suggest that with experience, educators adopt more child‐centred, responsive feeding practices and increased self‐efficacy in feeding that respect children's hunger and satiety cues, or that younger, less experienced educators may rely more on traditional or directive methods, perhaps due to a lack of confidence or familiarity with more nuanced approaches to feeding. ³²

Another finding from this study suggested that educators that have a higher level of education tended to use pressure strategies referring to the food itself, such as referring to foods as good/liked and encouraging the consumption of specific foods. This suggests that higher education may be associated with valuing certain foods more than others, possibly reflecting a greater emphasis on nutrition knowledge and the importance of healthy eating, which leads educators to highlight the quality or benefits of specific foods when encouraging children to eat. In studies comparing the feeding practices of educators based on a low (without university background/college diploma) or high (with university background/college diploma) education level, self‐reported pressure‐to‐eat occurred more often in the low education groups. ³³ , ³⁴ Another study among Norwegian educators also assessed a measure referred to as “encouraging balance and variety,” of which one component was telling the child that healthy food tastes good, and higher educated staff were significantly more likely to encourage balance and variety than lower educated staff, similar to our study fundings. ³⁴ While encouraging balance and variety is important, referring to healthy foods as tasting good may align with pressure‐to‐eat practices. This approach, possibly influenced by conventional nutrition education, highlights the need for a fundamental shift in how nutrition is taught and communicated by public health and early childhood education regulations. Instead of reinforcing pressure‐based messages, there is growing momentum toward food neutrality (i.e., reducing the dichotomy between “good” and “bad” foods) but there is also limited research on the impact on children. ³² , ³⁵ Further work is needed to explore how using a more neutral approach to language might influence pressure on children to eat more or less of certain foods.

Additional considerations of demographic differences between educators warrant further investigation into their influence on pressuring children to eat. Food and feeding practices vary among cultures, and since the observed educators are from diverse backgrounds, there is a chance that this affected the observed types and prevalence of pressure‐to‐eat, as this has been found in other studies on the topic of controlling feeding practices in parents and educators. ³³ , ³⁶ Gender and its related norms around feeding practices in early childhood education are another characteristic that warrant more research. The workplace is often dominated by women ³⁷ and research surrounding parent gender suggests differences such as greater pressure‐to‐eat and less monitoring of food intake from fathers. ³⁸ , ³⁹ Additionally, when trainee childhood educators in an Australian study were asked about their future role, some participants noted how they would act differently as an educator than they do as a parent, where their parenting practice involved more pressure‐like strategies. ⁴⁰ Thus, being a parent may impact behaviours in the early childhood setting towards correcting poor behaviour or acting in the same way as they would with their own children. Concern about food waste and/or the presence of food insecurity may also increase the use of pressure‐to‐eat, which has been found in studies looking at parent ⁴¹ and educator ⁴² feeding practices—and may also be present in child care, particularly with the increasing cost of food. Although this information was not collected from participating educators in this study, the influence of the dual roles of educator–parents and implications of food insecurity is an important future area of study.

Research has investigated why educators pressure children to eat, often citing concerns such as limited food intake, poor appetite, or are underweight. ⁴ , ⁶ , ⁹ , ¹⁰ , ¹¹ , ²³ Another common reason is the fear of negative responses from parents if children do not consume much throughout the day. ⁶ Pressure‐to‐eat generally stems from well‐intended concerns for children's health. ³ , ⁹ Some educators report using pressure because they believe it is the only effective method to encourage children to eat, ⁶ especially with selective eaters. ⁹ , ²³ However, prior research has demonstrated the opposite: a positive correlation between the use of pressure and selective eating, suggesting that it is an important and mistaken assumption made by many educators. ⁹ , ⁴³ , ⁴⁴ , ⁴⁵ Other recent research also calls for a bi‐directional understanding of selective eating, with a paradigm shift to appreciate how selective eating could grow out of pressuring caregiver behaviours. ⁴⁶ Based on this information, it is probable that educators pressuring selective eaters are unaware of the potential implications and are merely trying to promote the consumption of a variety of foods out of concern for the child. Overall, previous studies illustrate a consistent theme relating to why educators pressure children to eat, which is that they desire to increase the variety of textures and flavours children eat to ensure they consume adequate nutrients that aid in their growth and development.

Overall, this study looked at an aspect of child care feeding environments that has not been well investigated. The findings also provide important context of pressure‐to‐eat in child care feeding environments in the Canadian Maritime provinces, which may be transferable to international child care contexts of high‐income countries. The specific examples of language and actions that were highlighted provide insight into how pressure is commonly exhibited. It also highlights what types of pressure‐to‐eat are most common, potentially informing future educator training or other interventions. However, it should be noted that the nature of observing educators during data collection has its limitations as it is not a true naturalistic environment. It is common for individuals to act differently when they know they are being observed, as it can bring forward feelings of self‐consciousness and result in conformity to what they believe the observers are looking for. Further, feelings and opinions are not observed, meaning there is no way to know why educators said a specific phrase or performed specific actions. The use of a directed content analysis may also be limited as previous research formed the basis of the analysis, which can introduce bias and increase supportive results. ¹⁶ Additionally, the occasional simultaneous coding of pressure subtypes may have inflated the number of actual instances of pressure. Lastly, the use of average demographic variables for educators by child care centre, which includes only those educators who responded to the survey, is a limitation. This approach may lead to biased or incomplete representations of the entire educator population at each centre, as non‐respondents might differ in key demographic factors such as age, experience, or educational background. Additionally, since pressure data were only available at the centre level, we aggregated demographic data accordingly rather than by individual response, which may obscure within‐centre variability and potentially weaken the strength or accuracy of correlations between educator demographics and pressure subtypes. Future research could collect pressure data by individual educators to mitigate this issue and should also explore other ways to characterise pressure among child care programs and the specific knowledge and motivations that influence educator use of these strategies.

This study illuminates the manifestation and frequency of pressure in child care feeding environments. The results showed that the education and years of experience working in early childhood education may have played a role in the type of pressure used. Further, the most commonly used type of pressure was failing to reference hunger and satiety at mealtimes, while the least common type was referring to health benefits or consequences. It can be challenging for early learning centres to work towards a responsive feeding environment because prior research suggests that many educators do not realise they are pressuring children to eat. ³ , ²³ The information obtained from this study may identify priority areas where educators need support to implement more responsive feeding practices, such as promoting self‐regulation by helping children recognise and respond to their own hunger and fullness cues. Future research and intervention support are needed to better understand how to help educators recognise the negative effects of implementing pressure and enable them to use more responsive strategies. Along with professional development, individualised coaching may help identify personal biases that may be contributing toward problematic pressure‐to‐eat practices for educators. Practical tools such as posters or quick‐reference guides with suggested alternative phrases (e.g., “Instead of offering praise for eating a food, try praising mealtime behaviours other than eating, such as saying please, helping set the table, or practicing a new skill.”) could also support the use of more autonomy‐supportive, responsive interactions during mealtimes. ⁴⁷ Reducing pressure‐to‐eat will help to foster healthier relationships with food, allowing children to make autonomous decisions about their eating based on internal signals rather than external prompts.

AUTHOR CONTRIBUTIONS

HP wrote the initial draft of the manuscript as part of her honours thesis with analytical support from JC under the supervision of JDM. JDM and MR designed the broader project design. All authors were involved in the interpretation of the findings, critically reviewed the manuscript and contributed to, and agreed upon, the final version to be submitted for publication consideration. The authors acknowledge the support from Sarah Caldwell, Margaret Young, Elizabeth Dickson, Rachel Barich, and Olga Levin in data collection and analysis.

FUNDING INFORMATION

The Canadian Institutes of Health Research (#437465) and the Levesque Foundation funded this research. This research was also undertaken, in part, using funding from the Canada Research Chairs program (#950‐231877).

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

ETHICS STATEMENT

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the University of Prince Edward Island Research Ethics Board #6010388 and Mount Saint Vincent University Research Ethics Board # 2021‐112. Written informed consent was obtained from all participants.

Supporting information

Data S1. Supporting Information.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.