Exploring the Relationships Between Mothers’ Use of Food to Soothe, Feeding Type and Mode, Maternal Feeding Style, Infant Behavior, and Infant Weight-Related Outcomes During Early Infancy

Rapid infant weight gain (RWG) in the first six months postpartum is a strong predictor for obesity during childhood and adolescence. Although biological factors can influence infant weight gain trajectories, the modifiable factor of parent feeding practices can also have an influence. The use of food to soothe (FTS), or the act of feeding a child when he/she is upset for reasons other than hunger, has been associated with unhealthy eating behaviors and less-favorable weight outcomes in children and older infants. However, limited studies have explored the use of FTS during early infancy before the introduction of solids foods. The present study was a secondary analysis of mothers who completed previous infant feeding studies (n = 134) and was aimed at exploring whether maternal-reported use of FTS was associated with greater infant weight gain during the first six months postpartum and whether feeding type (exclusive breastfeeding versus exclusive formula-feeding versus mixed feeding) or bottle-feeding intensity (percent of daily feedings from a bottle) moderated this association. Both maternal-reported and observational measures of maternal and infant characteristics and their associations with the use of FTS were also explored. Individual correlations as well as multiple and logistic regressions were used to assess whether FTS predicted change in weight-for-age, weight-for-length, and/or RWG from birth to study entry. One-way ANOVA tests were used to assess the differences in use of FTS by feeding type and/or bottle-feeding intensity. Individual correlations and multiple regressions were used to assess whether maternal feeding style and/or infant temperament, clarity of cues, and/or eating behavior predicted the use of FTS. The mean age for infants was 14.8 weeks (SD = 7.1, range = 1.7 - 31.0 weeks). The results showed that the use of FTS had a significant negative association with percent of daily feedings from a bottle (r = -0.20, p = 0.021), and a significantly higher association among mothers who reported mixed feeding (M = 2.87, SD = 0.20) versus exclusive formula feeding (M = 2.20, SD = 0.20). Greater pressuring feeding, greater infant negativity, and lower infant surgency were all significant predictors for the use of FTS (p \u3c 0.05). FTS was not significantly associated with infant weight gain during the first 6 months postpartum. Neither feeding type or bottle-feeding intensity moderated the relationship between the use of FTS and infant weight gain. Future studies would benefit from recruiting a more diverse sample population, including measures of FTS that have been validated on infants younger than 3 months, and following the infants at more frequent time points from birth to 6 months postpartum

Mother–infant Interactions and Infant Intake during Breastfeeding Versus Bottle-feeding Expressed Breast Milk

Bottle-fed infants are at higher risk for rapid weight gain compared with breastfed infants. Few studies have attempted to disentangle effects of feeding mode, milk composition and relevant covariates on feeding interactions and outcomes. The objective of the present study was to compare effects of breastfeeding directly at the breast versus bottle-feeding expressed breast milk on feeding interactions. Mothers with \u3c6-month-old infants (n = 47) participated in two counterbalanced, feeding observations. Mothers breastfed their infants directly from the breast during one visit (breast condition) and bottle-fed their infants expressed breast milk during the other (bottle condition). Masked raters later coded videos using the Nursing Child Assessment Parent–Child Interaction Feeding Scale. Infant intake was assessed. Mothers self-reported sociodemographic characteristics, infant feeding patterns (i.e. percentage of daily feedings from bottles) and level of pressuring feeding style. Mother and infant behaviours were similar during breast and bottle conditions. Percent bottle-feeding moderated effects of condition on intake (P = 0.032): greater percent bottle-feeding predicted greater intake during the bottle compared with breast condition. Effects of feeding mode were not moderated by parity or pressuring feeding style, but, regardless of condition, multiparous mothers fed their infants more than primiparous mothers (P = 0.028), and pressuring feeding style was positively associated with infant intake (P = 0.045). Findings from the present study do not support the hypothesis that feeding mode directly impacts dyadic interaction for predominantly breastfeeding mothers and infants, but rather suggest between-subject differences in feeding experiences and styles predict feeding outcomes for this population

Associations Between Mothers’ Use of Food to Soothe, Feeding Mode, and Infant Weight During Early Infancy

Weight status and rate of weight gain in the first six months postpartum are strong predictors of later obesity; thus, infant feeding practices are an important target for obesity prevention efforts. The use of food to soothe (FTS) is associated with less-favorable eating habits and weight outcomes for older infants and children. However, few studies have examined correlates of use of FTS during early infancy. The primary aim of this cross-sectional study was to explore associations between use of FTS and infant weight status in the first 6 months postpartum. A secondary aim was to identify the combination of maternal and infant characteristics that predicted use of FTS. Mothers of infants aged 6 months or younger (N = 134) completed questionnaires assessing use of FTS, bottle-feeding intensity (i.e., percentage of daily feedings from bottles versus directly from the breast), levels of responsive and pressuring feeding styles, dimensions of infant temperament and eating behaviors, and family demographics. Dyads were observed during feeding to assess maternal sensitivity to infant cues and responsiveness to infant distress and infant clarity of cues and responsiveness to the mother. Infant weight and length at study entry were assessed by a trained research assistant. Use of FTS was not associated with infant weight for age z-score (WAZ), even when bottle-feeding intensity was considered as a moderator. More frequent use of FTS was predicted by the combination of greater levels of pressuring feeding style (p = .005) and infant temperamental negative affectivity (p = .001), and lower levels of infant temperamental surgency/extraversion (p = .018). In conclusion, use of FTS was associated with dimensions of infant temperament and maternal feeding style, but not with WAZ during early infancy