Maternal sensitivity during mealtime and free play: differences and explanatory factors

Mealtime is a parent-toddler interaction that occurs multiple times a day. This study examined whether observed maternal sensitivity differed between a mealtime and free-play setting, aiming to explain differences between the two situations by studying moderating effects of children's eating behavior. The sample consisted of 103 first-time mothers and their 18-month-old children. Maternal sensitivity was assessed by coding videotaped interactions of free-play sessions and mealtimes, using the Ainsworth Sensitivity Scale (range 1-9). Additionally, child eating behavior during the meal was coded and also assessed through the Child Eating Behavior Questionnaire-Toddlers. First, a small but significant amount of stability was found between sensitivity during mealtime and sensitivity during play (r = 0.24). Second, mothers were more sensitive during free play (mean = 7.11) than during mealtime (mean = 6.52). Third, observed child eating behavior was related to maternal sensitivity during mealtime, with more food enjoyment being associated with higher levels of sensitivity, and more challenging child behavior with lower levels of sensitivity. Finally, when children showed a high degree of challenging behavior during the meal, there was more discrepancy between sensitivity during mealtime and free play. Our results highlight the importance of taking context into account when observing parental sensitivity.Education and Child Studie

Baby's first bites: association between observed maternal feeding behavior and infant vegetable intake and liking

Positive experiences with the introduction of solid food in infancy may lead to positive associations with feeding in both parent and infant. During this transitional period, parental feeding behavior and infant eating behavior might mutually reinforce each other. A feeding style that is found to be associated with positive child eating behavior, is sensitive feeding. In the present study we tested bidirectional prospective relations between mother and infant behavior in a cross-lagged model using observations of two feeds on two consecutive days on which the first bites of solid food were offered. The sample consisted of 246 first-time mothers and their infants, whose feeding interactions were videotaped during two home visits. Maternal sensitive feeding behavior (consisting of responsiveness to child feeding cues, general sensitivity and non-intrusiveness) and maternal positive and negative affect were coded. In addition, infant vegetable intake was weighed and vegetable liking was reported by mother. Results showed at least some stability of maternal feeding behavior and infant vegetable intake and liking from the first to the second feed. In addition, during the second feed maternal sensitive feeding and positive affect were associated with infant vegetable intake (r=.34 and r=.14) and liking (r=.33 and r=.39). These associations were mostly absent during the first feed. Finally, infant vegetable liking during the first feed positively predicted maternal sensitive feeding behavior during the second feed (β=.25), suggesting that the infant's first response might influence maternal behavior. Taken together, mother and infant seem more attuned during the second feed than during the first feed. Future studies might include multiple observations over a longer time period, or micro-coding. Such insights can inform prevention programs focusing on optimizing feeding experiences during the weaning period.Education and Child Studie

The baby's first bites RCT: evaluating a vegetable-exposure and a sensitive-feeding intervention in terms of child health outcomes and maternal feeding behavior during toddlerhood

Education and Child Studie

Detection of Gluten in Duplicate Portions to Determine Gluten Intake of Celiac Disease Patients on A Gluten Free Diet

This study determined the gluten content of foods and meals consumed by celiac disease (CD) patients who adhere to a gluten free diet, and to estimate the total daily intake of gluten of these patients. CD patients fulfilling defined inclusion criteria were preselected and approached for participation in the study. Duplicate portions (DP) of foods and mixed dishes were collected from the CD patients for evaluating complete daily food intake during two individual days. Also, for these days written food records were completed by the participants. From each DP a laboratory sample was prepared, analysed for its gluten concentration and total daily gluten intake was calculated. Individual's total daily intakes of energy and macronutrients were calculated using the Dutch food composition database.In total 27 CD patients participated, 7 males and 20 females, aged between 21 and 64 years. In 32 (6%) of in total 499 food samples collected, more than 3 mg/kg gluten was present. In four of these 32 samples, the gluten concentration was above the European legal limit of 20 mg/kg and 3 of the 4 samples had a gluten-free label.The maximal gluten intake was 3.3 mg gluten per day. The gluten tolerance for sensitive CD patients (> 0.75 mg per day) was exceeded on at least 6 out of 54 study days. To also protect these sensitive CD patients, legal thresholds should be re-evaluated and the detection limit of analytical methods for gluten analysis lowered. </p

Eating in the absence of hunger in 18-month-old children in a home setting

BACKGROUND\nOBJECTIVES\nMETHODS\nRESULTS\nCONCLUSION\nEating in the absence of hunger (EAH), the susceptibility to eat despite satiety, may increase overweight. While EAH has been established in school-aged children, less is known about it during toddlerhood.\nThis study assessed to what extent 18-month-old children eat in the absence of hunger, the stability of this behaviour at 24 months and the association of child eating behaviours with EAH.\nChildren were presented with four palatable finger foods (total 275 kcal) after dinner. Univariate GLM's assessed the association between EAH, child satiety and eating behaviours and energy intake of dinner at 18 and 24 months (n = 206 and 103, respectively). Another GLM was run to assess the association between EAH at both time points.\nMean (±SD) energy intakes from dinner and finger foods were 240 kcal (±117) and 40 kcal (±37), respectively. No association was found between energy intake of dinner and finger foods. Enjoyment of food was significantly related to intake of finger foods (P = .005). EAH at 18 months predicted EAH at 24 months.\nEighteen-month-old children ate in the absence of hunger, irrespective of satiety. Thus, preceding energy intake was not compensated for. Other factors, for example, enjoyment of food seem to determine finger food intake.NWO057-14-002Education and Child Studie

The baby’s first bites RCT: evaluating a vegetable-exposure and a sensitive-feeding intervention in terms of child health outcomes and maternal feeding behavior during toddlerhood

Education and Child Studie

Baby's first bites: a randomized controlled trial to assess the effects of vegetable-exposure and sensitive feeding on vegetable acceptance, eating behavior and weight gain in infants and toddlers

BACKGROUND: The start of complementary feeding in infancy plays an essential role in promoting healthy eating habits. Evidence shows that it is important what infants are offered during this first introduction of solid foods: e.g. starting exclusively with vegetables is more successful for vegetable acceptance than starting with fruits. How infants are introduced to solid foods also matters: if parents are sensitive and responsive to infant cues during feeding, this may promote self-regulation of energy intake and a healthy weight. However, the effectiveness of the what and the how of complementary feeding has never been experimentally tested in the same study. In the current project the what and how (and their combination) are tested in one study to determine their relative importance for fostering vegetable acceptance and self-regulation of energy intake in infants. METHODS: A four-arm randomized controlled trial (Baby's First Bites (BFB)) was designed for 240 first-time Dutch mothers and their infants, 60 per arm. In this trial, we compare the effectiveness of (a) a vegetable-exposure intervention focusing on the what in complementary feeding; (b) a sensitive feeding intervention focusing on the how in complementary feeding, (c) a combined intervention focusing on the what and how in complementary feeding; (d) an attention-control group. All mothers participate in five sessions spread over the first year of eating solid foods (child age 4-16 months). Primary outcomes are vegetable consumption, vegetable liking and self-regulation of energy intake. Secondary outcomes are child eating behaviors, child anthropometrics and maternal feeding behavior. Outcomes are assessed before, during and directly after the interventions (child age 18 months), and when children are 24 and 36 months old. DISCUSSION: The outcomes are expected to assess the impact of the interventions and provide new insights into the mechanisms underlying the development of vegetable acceptance, self-regulation and healthy eating patterns in infants and toddlers, as well as the prevention of overweight. The results may be used to improve current dietary advice given to parents of their young children on complementary feeding. TRIAL REGISTRATION: The trial was retrospectively registered during inclusion of participants at the Netherlands National Trial Register (identifier NTR6572 ) and at ClinicalTrials.gov ( NCT03348176 ). Protocol issue date: 1 April 2018; version number 1.</p

Baby's first bites: a randomized controlled trial to assess the effects of vegetable-exposure and sensitive feeding on vegetable acceptance, eating behavior and weight gain in infants and toddlers

BACKGROUND: The start of complementary feeding in infancy plays an essential role in promoting healthy eating habits. Evidence shows that it is important what infants are offered during this first introduction of solid foods: e.g. starting exclusively with vegetables is more successful for vegetable acceptance than starting with fruits. How infants are introduced to solid foods also matters: if parents are sensitive and responsive to infant cues during feeding, this may promote self-regulation of energy intake and a healthy weight. However, the effectiveness of the what and the how of complementary feeding has never been experimentally tested in the same study. In the current project the what and how (and their combination) are tested in one study to determine their relative importance for fostering vegetable acceptance and self-regulation of energy intake in infants. METHODS: A four-arm randomized controlled trial (Baby's First Bites (BFB)) was designed for 240 first-time Dutch mothers and their infants, 60 per arm. In this trial, we compare the effectiveness of (a) a vegetable-exposure intervention focusing on the what in complementary feeding; (b) a sensitive feeding intervention focusing on the how in complementary feeding, (c) a combined intervention focusing on the what and how in complementary feeding; (d) an attention-control group. All mothers participate in five sessions spread over the first year of eating solid foods (child age 4-16 months). Primary outcomes are vegetable consumption, vegetable liking and self-regulation of energy intake. Secondary outcomes are child eating behaviors, child anthropometrics and maternal feeding behavior. Outcomes are assessed before, during and directly after the interventions (child age 18 months), and when children are 24 and 36 months old. DISCUSSION: The outcomes are expected to assess the impact of the interventions and provide new insights into the mechanisms underlying the development of vegetable acceptance, self-regulation and healthy eating patterns in infants and toddlers, as well as the prevention of overweight. The results may be used to improve current dietary advice given to parents of their young children on complementary feeding. TRIAL REGISTRATION: The trial was retrospectively registered during inclusion of participants at the Netherlands National Trial Register (identifier NTR6572 ) and at ClinicalTrials.gov ( NCT03348176 ). Protocol issue date: 1 April 2018; version number 1.</p