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Development of Feeding Cues During Infancy and Toddlerhood
Eric A Hodges1, Heather M Wasser, Brook K Colgan
1Eric A. Hodges is an Associate Professor, University of North Carolina-Chapel Hill, School of Nursing, Chapel Hill, N.C. The author can be reached via e-mail at eahodges@email.unc.eduHeather M. Wasser is a Research Assistant Professor, Center for Women's Health Research, University of North Carolina-Chapel Hill, School of Medicine, Chapel Hill, N.C.Brook K. Colgan is Vice President and Director of Training for WISE (Women-Inspired Systems' Enrichment) in Chapel Hill, N.C.Margaret E. Bentley is a Professor, University of North Carolina-Chapel Hill, Gillings School of Global Public Health, Chapel Hill, N.C.
Insights
Infants develop more intentional feeding cues over their first 18 months, shifting from early signs to active communication. Understanding these infant feeding cues aids responsive feeding and obesity prevention.
Area of Science:
- Child Development
- Nutrition Science
- Pediatric Health
Background:
- Responsive feeding is crucial for healthy infant growth and development.
- Understanding the evolution of infant feeding cues is essential for supporting responsive feeding practices.
- Early identification of feeding cues can help prevent overfeeding and mitigate risks of childhood obesity.
Purpose of the Study:
- To characterize the developmental trajectory of infant and toddler feeding cues.
- To provide an empirical description of how feeding cues change from infancy to toddlerhood.
- To inform strategies for enhancing parental responsiveness to infant feeding cues.
Main Methods:
- Secondary analysis of video-recorded home feedings from a dataset of low-income African American mother-infant pairs.
- Assessment of early, active, and late receptiveness and fullness cues using the Responsiveness to Child Feeding Cues Scale at 3, 6, 9, 12, and 18 months.
- Selection of a subsample (n=45) based on infant body mass index (BMI) Z-scores at 18 months to analyze cue development.
Main Results:
- Active receptiveness cues were more common than early receptiveness cues throughout the study period.
- Infant cues evolved, with settling decreasing and postural attention/reaching increasing after 6 months.
- Fullness cues shifted from early signs (e.g., sleepiness) to more active, assertive signals (e.g., pushing away, verbal "no") after 6 months.
Conclusions:
- Feeding cues demonstrate increasing intentionality and diversity from infancy through toddlerhood.
- Knowledge of developmental feeding cues can help clinicians improve parental responsiveness.
- Enhanced responsive feeding practices informed by cue development may reduce the risk of early childhood obesity.
Purpose:
To enhance responsive feeding, this study aimed to characterize the development of feeding cues during infancy and toddlerhood.
Study Design And Methods:
A secondary analysis was performed on a dataset of first-time, low-income African American mother-infant pairs assessed at infant age 3, 6, 9, 12, and 18 months. A subsample with the 15 highest, middle, and lowest infant body mass index (BMI) Z-scores at 18 months was selected (n = 45). Using video-recorded home feedings, early, active, and late receptiveness and fullness cues were assessed using the Responsiveness to Child Feeding Cues Scale at each time point. Descriptive statistics were used to characterize development.
Results:
Early receptiveness cues were relatively rare over time, whereas active receptiveness cues were much more common. However, there were changes over time. For example, settling into the feeding decreased from ~50% at 3 and 6 months to 4.8% by 18 months, whereas postural attention and reaching for food increased after 6 months. In the first 6 months, falling asleep and decreasing muscle tone and activity level were the most common early fullness cues. Thereafter, taking interest in surroundings was most prevalent. Active fullness cues became increasingly diverse after 6 months, led by more assertive cues such as pushing or pulling away and communicating "no" verbally or nonverbally.
Clinical Implications:
These findings provide an empirical description of waxing and waning in feeding cues and indicate increasing intentionality of cues over the first 18 months of life. Knowing common cues across development may aid clinicians in enhancing parental feeding responsiveness, avoiding overfeeding, thereby decreasing risk of early childhood obesity.
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