Effectiveness of Tuina Massage and Mindful Eating on Improving Appetite in Toddlers with Feeding Difficulties
Abstract
Eating difficulties in toddlers are a common problem and can impact their growth and nutritional status. One effort that can be made to overcome this problem is through an approach to eating behavior and digestive stimulation. This study aims to analyze the effectiveness of mindful eating and Tuina massage on toddlers' eating behavior. This study used a quasi-experimental design with a pretest–posttest with control group design. The study sample consisted of 70 toddlers divided into two groups: 35 toddlers in the intervention group who were given mindful eating and Tuina massage and 35 toddlers in the control group who were given nutrition education. Data analysis used the Wilcoxon test to see the difference before and after the intervention and the Mann–Whitney test to see the difference between the groups. The results showed that in the intervention group there was a decrease in eating difficulties from 100% to 11.43%, while in the control group it decreased from 100% to 34.29%. The results of the Mann–Whitney test showed a p value = 0.024 (p < 0.05), meaning there was a significant difference between the two groups. It can be concluded that mindful eating and Tuina massage interventions are more effective in improving toddlers' eating behaviors than nutrition education alone. This intervention can be an alternative non-pharmacological approach that parents can implement to address eating difficulties in toddlers.
Keywords: Tuina Massage, Mindful Eating, Eating Behavior, Toddlers
Full Text:
PDFReferences
Atkinson, C., Monk, V. C., Ness, A. R., Lewis, S. J., Longman, R. J., Thomas, S. J., Leary, S. D., Hollingworth, W., & Penfold, C. M. (2020). Factors associated with early postoperative feeding: An observational study in a colorectal surgery population. Clinical Nutrition ESPEN, 36, 99–105. https://doi.org/https://doi.org/10.1016/j.clnesp.2020.01.009
Bai, X., Zhu, Q., Tian, Y., Guo, L., Liu, J., Shen, M., & Wang, C. (2025). Long-term symptom recurrence and functional outcomes with Chinese ointment massage, Tuina, and combined acupuncture for knee osteoarthritis: A 24-month multicenter real-world study in China. Complementary Therapies in Medicine, 93, 103220. https://doi.org/https://doi.org/10.1016/j.ctim.2025.103220
Bennett, B. L., & Latner, J. D. (2022). Mindful eating, intuitive eating, and the loss of control over eating. Eating Behaviors, 47, 101680. https://doi.org/https://doi.org/10.1016/j.eatbeh.2022.101680
Beshara, M., Hutchinson, A. D., & Wilson, C. (2013). Does mindfulness matter? Everyday mindfulness, mindful eating and self-reported serving size of energy dense foods among a sample of South Australian adults. Appetite, 67, 25–29. https://doi.org/https://doi.org/10.1016/j.appet.2013.03.012
CUI, L., ZHANG, X., & LI, Z. (2019). Tuina for infant congenital muscular torticollis: A randomized controlled trial. World Journal of Acupuncture - Moxibustion, 29(3), 186–189. https://doi.org/https://doi.org/10.1016/j.wjam.2019.08.002
D’Hollander, C. J., Keown-Stoneman, C. D. G., Birken, C. S., O’Connor, D. L., Maguire, J. L., Cohn, R., Lau, E., Laupacis, A., Parkin, P. C., Salter, M., Szatmari, P., Weir, S., Anderson, L. N., Borkhoff, C. M., Kowal, C., Mason, D., Abdurrahman, M., Anderson, K., Arbess, G., … Vandenberghe, H. (2022). Timing of Introduction to Solid Food, Growth, and Nutrition Risk in Later Childhood. The Journal of Pediatrics, 240, 102-109.e3. https://doi.org/https://doi.org/10.1016/j.jpeds.2021.08.076
Durukan, A., & Gül, A. (2019). Mindful eating: Differences of generations and relationship of mindful eating with BMI. International Journal of Gastronomy and Food Science, 18, 100172. https://doi.org/https://doi.org/10.1016/j.ijgfs.2019.100172
Eldridge, A. L., Catellier, D. J., Hampton, J. C., Dwyer, J. T., & Bailey, R. L. (2019). Trends in Mean Nutrient Intakes of US Infants, Toddlers, and Young Children from 3 Feeding Infants and Toddlers Studies (FITS). The Journal of Nutrition, 149(7), 1230–1237. https://doi.org/https://doi.org/10.1093/jn/nxz054
Goodman, L. C., Roberts, L. T., & Musher-Eizenman, D. R. (2020). Mindful feeding: A pathway between parenting style and child eating behaviors. Eating Behaviors, 36, 101335. https://doi.org/https://doi.org/10.1016/j.eatbeh.2019.101335
Herrmann, T., Preib, E., French, M., Beckstrom, J., Nazarenko, E., Lackner, R., Marchand, W. R., & Yabko, B. (2022). Veterans’ experiences with mindfulness-based eating: A mixed methods study on MB-SAVOR. Complementary Therapies in Clinical Practice, 47, 101548. https://doi.org/https://doi.org/10.1016/j.ctcp.2022.101548
ICIMH 2020 Abstracts. (2020). Global Advances in Health and Medicine, 9. https://doi.org/10.1177/2164956120912849
Ji, E. S., Lee, K. J., & Chung, Y. C. (2026). Systematic Review of Studies Investigating Infant Feeding Difficulties: Focus on Machine Learning Applications. Journal of Pediatric Health Care, 40(4), 493–503. https://doi.org/https://doi.org/10.1016/j.pedhc.2026.01.009
Jiang, S., Zhang, H., Fang, M., Zhang, Y., Lu, N., Zhu, Q., Cheng, Y., Ai, J., Zhou, N., Li, J., Fang, L., & Yao, F. (2016). Analgesic effects of Chinese Tuina massage in a rat model of pain. Experimental and Therapeutic Medicine, 11(4), 1367–1374. https://doi.org/10.3892/etm.2016.3055
Kim de Oliveira da Fonseca, N., Rocha dos Santos, G., Foppa, G. T., Nunes da Luz Morelo, G., Santos, A. Z., Weydmann, G., Boaventura, B., Flint, S. W., Antunes, L. C., Brietzke, E., & Manfro, G. G. (2026). Mindfulness-based eating in obesity and anxiety: a randomized controlled trial and feasibility assessment. The Lancet Regional Health - Americas, 59, 101541. https://doi.org/https://doi.org/10.1016/j.lana.2026.101541
Lanyo, T. N., Zielinski, R., Kukula, V. A., Apetorgbor, V. E., Ghosh, B., Lockhart, N. A., & Lori, J. R. (2025). Improving respectful maternity care through group antenatal care: Findings from a cluster randomized controlled trial. Midwifery, 147, 104457. https://doi.org/https://doi.org/10.1016/j.midw.2025.104457
Maitin-Shepard, M., O’Tierney-Ginn, P., Kraneveld, A. D., Lyall, K., Fallin, D., Arora, M., Fasano, A., Mueller, N. T., Wang, X., Caulfield, L. E., Dickerson, A. S., Diaz Heijtz, R., Tarui, T., Blumberg, J. B., Holingue, C., Schmidt, R. J., Garssen, J., Almendinger, K., Lin, P.-I. D., & Mozaffarian, D. (2024). Food, nutrition, and autism: from soil to fork. The American Journal of Clinical Nutrition, 120(1), 240–256. https://doi.org/https://doi.org/10.1016/j.ajcnut.2024.04.020
Marshall, J., Clarke, S., Escott, C., & Pados, B. F. (2021). Assessing the flow rate of different bottles and teats for neonates with feeding difficulties: An Australian context. Journal of Neonatal Nursing, 27(4), 285–290. https://doi.org/https://doi.org/10.1016/j.jnn.2020.11.014
Nielsen, M. M., Maribo, T., Westergren, A., & Melgaard, D. (2018). Associations between eating difficulties, nutritional status and activity of daily living in acute geriatric patients. Clinical Nutrition ESPEN, 25, 95–99. https://doi.org/https://doi.org/10.1016/j.clnesp.2018.03.128
Razza, R., & Brann, L. (2025). Integrating Social Emotional Learning, mindfulness, and nutrition education into curricula to promote self-regulation and healthy eating behaviors among preschoolers. Social and Emotional Learning: Research, Practice, and Policy, 5, 100081. https://doi.org/https://doi.org/10.1016/j.sel.2025.100081
Russo, E., Gupta, R., & Merriman, L. (2016). Implementing the Care Plan for Patients Diagnosed with Malnutrition—Why Do We Wait? Journal of the Academy of Nutrition and Dietetics, 116(5), 865–867. https://doi.org/https://doi.org/10.1016/j.jand.2016.03.005
SAK, I., & Soetjiningsih. (2012). Kesulitan Makan Pada Anak. Tumbuh Kembang Anak.
Siddiqui, Z., Shaida, B., Joshi, S., & Hasan, S. (2026a). Impact of mindfulness-based eating programs on mental health outcomes in adults: A systematic review. Appetite: Disordered Eating, 2, 100007. https://doi.org/https://doi.org/10.1016/j.appde.2026.100007
Siddiqui, Z., Shaida, B., Joshi, S., & Hasan, S. (2026b). Impact of mindfulness-based eating programs on mental health outcomes in adults: A systematic review. Appetite: Disordered Eating, 2, 100007. https://doi.org/https://doi.org/10.1016/j.appde.2026.100007
Siracusano, M., Arturi, L., Riccioni, A., Medoro, A., Savino, R., Scapagnini, G., Davinelli, S., & Mazzone, L. (2025). Feeding difficulties, eating disorders and therapeutic approaches in autism spectrum disorder: An overview. Pharmacological Research, 222, 108040. https://doi.org/https://doi.org/10.1016/j.phrs.2025.108040
Sutherland, R., Katz, T., Liu, V., Quintano, J., Brunner, R., Tong, C. W., Collins, C. E., & Ooi, C. Y. (2018). Dietary intake of energy-dense, nutrient-poor and nutrient-dense food sources in children with cystic fibrosis. Journal of Cystic Fibrosis, 17(6), 804–810. https://doi.org/https://doi.org/10.1016/j.jcf.2018.03.011
Xu, H., Wang, Z., Wang, Z., Zhou, H., Li, W., Guo, J., Xie, Y., & Zhou, Y. (2023). Scientific knowledge graph and trend analysis of Tuina: A bibliometric analysis. Complementary Therapies in Medicine, 79, 103005. https://doi.org/https://doi.org/10.1016/j.ctim.2023.103005
Zhang, S., Han, Y., Zhang, L., Tan, F., Huang, X., Zhang, C., Yao, Z., Xiong, L., & Tai, X. (2026). Efficacy of Tuina for Myopia in Children: Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 15. https://doi.org/https://doi.org/10.2196/79324
DOI: http://dx.doi.org/10.30829/contagion.v8i1.27673
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 halimatus saidah
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
