2.2. Questionnaire translation and revision

After obtaining consent from the author of the BEBQ (Llewellyn et al., ²⁰¹¹), apaediatrician and anative‐Chinese‐speaking English teacherindependently translated the questionnaire into Chinese. Item meaning and wording were compared between these two translated drafts, and after careful panel discussion the translated items that were most concordant with the originals were chosen for inclusion in the draft translated version of the BEBQ. The panel consisted of seven experts in paediatrics, statistics, the English language, child psychology and nutrition. A paediatrician and a medical statistics professor who had lived and studied in Canada for many years back‐translated the Chinese version of the draft into English together. After comparison of the original and retranslated versions, items with differences were reported to the panel again, and a second round of translation and correction was carried out as necessary to yield items with meanings that were consistent with the original items.

Then, a survey was conducted to test the draft Chinese BEBQ with 100 family members of children who visited the paediatric outpatient departments of major hospitals in Xi'an during a 1‐week period. Omission rates were high (>5%) and discrimination was low (skewness ~±1, coefficient of variation <0.25) for items 4, 7 and 10 (Table 1), which were removed after paneldiscussion to avoid misunderstanding or lack of precision in responses. These items reflect differences between Chinese and western cultures. The concept of appetite is not referred to often in Chinese culture, and many Chinese parents dote on their children due to the national one‐child policy, which results in their unawareness of their children's satiety and a persistent feeling that their children do not eat enough. Thus, the final revised Chinese version of the BEBQ has 15 items. The scoring method is the same as for the original questionnaire.

TABLE 1

Chinese Baby Eating Behaviour Questionnaire items and statistical characteristics

3.2. Item screening results

All items scores were >0.85 and factor loadings were >0.4, and the Cronbach's α coefficient for the scale was not greater after the removal of any item. Thus, all BEBQ items were appropriate and screening did not result in the removal of any BEBQ item (Table 3).

TABLE 3

Chinese Baby Eating Behaviour Questionnaire item properties

4.2. Discrimination of the questionnaire

The satiety responsiveness and food responsiveness scores showed significant sex‐based differences in this study, consistent with the results reported for the original BEBQ (Llewellyn et al., ²⁰¹¹). Some studies conducted with older children have shown that boys have lower food satisfaction scores than do girls, and this difference can be inferred to have begun in infancy (Carnell & Wardle, ²⁰⁰⁸; Sleddens et al., ²⁰⁰⁸; Wardle et al., ²⁰⁰¹). These two dimension scores also differed significantly between preterm and full‐term infants, consistent with results reported for the original BEBQ and those of a study conducted by Cooke et al. (²⁰⁰⁴) and Cooke and Embleton (²⁰⁰⁰), suggesting that premature birth affects infants' appetites (Embleton et al., ²⁰⁰¹). The satiety responsiveness, food responsiveness and enjoyment of food dimension scores differed according to monthly weight gain, perhaps because poor dietary intake affects infants' growth and development (De Kroon et al., ²⁰¹¹; Lefebvre & John, ²⁰¹³; Li et al., ²⁰⁰⁸; Salgin et al., ²⁰¹⁵). We found no significant difference in the enjoyment of food, slowness in eating or satiety responsiveness score according to birth weight, as was observed for the original BEBQ in a sample of babies in the UK, which is, in turn, consistent with other findings linking birth weight to eating behaviour (Baird et al., ²⁰⁰⁵; Ong et al., ²⁰⁰⁶). Our results may be related to the weight increase of only 5.6% from birth in our sample. Original BEBQ satiety responsiveness and food responsiveness dimension scores also differed according to infants' feeding patterns, and epidemiological studies have yielded similar results (De Kroon et al., ²⁰¹¹; Gluckman et al., ²⁰⁰⁷; Harder et al., ²⁰⁰⁵; Owen et al., ²⁰⁰⁵), but we observed no such difference in this study.

We would like to acknowledge the valuable contributions to this manuscript of Clare H. Llewellyn of London University, who is the author of the Children's Eating Behaviour Questionnaire. The research team is grateful to all the children and their families who took part in this study, as well as the research assistants and coordinators involved in this study. Source of funding: National Natural Science Foundation of China (81773540). The Social Developing Research Funds of Shaanxi Province (2017SF‐005).