[Association of responsive feeding styles with optimal developmental trajectory of infants]

Objective: To explore the association between feeding styles and early developmental trajectories of infants aged 6-12 months. Methods: This prospective cohort study recruited 367 mother-infant dyads from a multicenter longitudinal study in China on feeding behavior and early development of infants aged 0-12 months between July 2019 and October 2024. Information about infants and their parents was collected through questionnaires. The weight of infants at 3 months of age was evaluated by performing physical examinations. Feeding styles of infants at 3 months of age were evaluated using the Infant Feeding Style Questionnaire (IFSQ), and the early development Z-scores of infants at 6, 9, and 12 months of age were evaluated by using the Caregiver Reported Early Development Instrument (CREDI) simplified version. The group-based trajectory model was used to identify potential categories of Z-score trajectories in early infant development. Multivariate logistic regression was performed to examine the association between feeding styles and early development Z-score trajectory. Results: Among the 367 mothers surveyed, 327 (89.1%) were aged ≤35 years at baseline, and 305 (83.1%) had a bachelor's degree or above. There were 188 male infants (51.2%), with an average weight of 6.4±0.8 kg at 3 months of age. In terms of feeding styles at 3 months of age, 163 infants (44.4%) were subject to high-frequency food restriction, 159 (43.3%) to high-frequency forced feeding, and 121 (33.0%) to high-frequency food-based soothing. About 121 infants (33.0%) had caregivers with high sensitivity to infant hunger and satiety cues, and only 37 (10.1%) had caregivers with close attention during infant feeding. Among infants aged 6-12 months, two potential early development Z-score trajectories were identified, with 304 (82.8%) in the "average early development" and 63 (17.2%) in the "optimal early development". Multivariate logistic regression showed that compared with infants who were forced to eat at low frequency at 3 months of age, frequent forced feeding reduced the likelihood of infants being in the "optimal early development" at 6-12 months of age (OR=0.48, 95%CI:0.26-0.91). Compared with infants who received less attention during feeding at 3 months of age, infants who received close attention were more likely to achieve "optimal early development" (OR=3.10, 95%CI:1.30-7.35). Conclusion: Responsive feeding styles may be associated with the optimal developmental trajectory of infants.