To Assess The Knowledge of Mothers on Hunger Cues in Infants Less Than 6months Under Different Feeding Methods
DOI:
https://doi.org/10.63682/jns.v14i19S.4844Keywords:
Infants, Hunger cues, Breastfeeding, Responsive feeding, MothersAbstract
Background Mothers’ perception of infant hunger cues is a critical content of responsive feeding, which is central to the promotion of early childhood development. However, only a few studies have examined responsive feeding in India, especially lacking the studies on perceptions of infant hunger cues.the aim of this study was to describe the perceptions of infant hunger cues of mothers for infants aged 6 months, and explore the relationship between maternal perceptions of infant hunger cues and different feeding methods.
Methods A cross-sectional study was conducted with a sample of 200 mothers of healthy infants. The study involves mothers filling out a previously tested structured questionnaire, which is provided after getting consent in both English and Tamil. The questionnaire has been pre-validated by our expert team. This study does not involve any other interventions. The aim of this study is to observe the responses from the questionnaire and come to conclusions about mothers' understanding of hunger cues in infants under six months under various nutritional methods. Mothers are recruited from postnatal wards, regular OPD visits , and vaccination OPD visits. The inclusion criteria are as follows: (a) the child must be full-term (≥ 37 weeks); (b) the child's birth weight must be 2000 grams or more; (c) the child must have been exclusively breastfed in the past 24 hours and no other foods (except medications and vitamins) added (for children in the EBF group), or not exclusively breastfed in the past 24 hours (for children in the FF group). The above information was obtained through interviews, and mothers were given sufficient time to reflect on their responses. Exclusions include: (a) children with health problems that could affect feeding abilities (for example, swallowing); (b) mothers or children with severe health problems that could affect the child's growth and/or development and/or include the mother's prenatal and/or postnatal complications; (c) mothers without reading and writing skills.
Results: sis revealed that EBF might support mothers to perceive infant hunger cues than FF mothers, with the number of infant hunger cues (OR = 1.70, 95% CI: 1.01–2.85), “hand sucking” (OR = 1.72, 95% CI: 1.04–2.87), “moving head frantically from side to side” (OR = 2.07, 95% CI: 1.19–3.62). The number of infant hunger cues perceived by mothers was also associated with their educational level and family structure.
Conclusion: EBF mothers of 6-month-old infants may be more likely to perceive infant hunger cues than FF mothers. It is necessary to increase the health education about infant hunger and satiety cues to caregivers, especially among mothers with lower education levels, mothers living in nuclear families, and FF mothers.
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Black MM, Aboud FE. Responsive feeding is embedded in a theoretical Framework of responsive parenting. J Nutr. 2011;141:490–4. doi: 10.3945/jn.110.129973. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Fang R, Xiaoyang S. Feeding patterns of infants during the complementary feeding period. Chin J Pediatr. 2015;53:153–5. [PubMed] [Google Scholar]
Meiling T. Responsive feeding of premature infants and infants. Chin J Practical Pediatr Clin Pract. 2017;32:1763–5. [Google Scholar]
DiSantis KI, Hodges EA, Johnson SL, Fisher JO. The role of responsive feeding in overweight during infancy and toddlerhood: a systematic review. Int J Obes. 2011;35:480–92. doi: 10.1038/ijo.2011.3. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Institute of Medicine (U.S.), Birch LL, Burns AC, Parker L, Institute of Medicine (U.S.), editors. Early childhood obesity prevention policies. Washington, D.C: National Academies Press; 2011.
Thompson AL, Adair LS, Bentley ME. Pressuring and restrictive feeding styles influence infant feeding and size among a low-income african-american sample: feeding Styles, Infant Diet, and size. Obesity. 2013;21:562–71. doi: 10.1002/oby.20091. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
World Health Organization, United Nations Children’s Fund (UNICEF) Protecting, promoting and supporting breastfeeding: the baby-friendly hospital initiative for small, sick and preterm newborns. Geneva: World Health Organization; 2020. [Google Scholar]
Fuglestad AJ, Demerath EW, Finsaas MC, Moore CJ, Georgieff MK, Carlson SM. Maternal executive function, infant feeding responsiveness and infant growth during the first 6 months: infant feeding. Pediatr Obes. 2017;12:102–10. doi: 10.1111/ijpo.12226. [PubMed] [CrossRef] [Google Scholar]
Mesman J, Emmen RAG. Mary Ainsworth’s legacy: a systematic review of observational instruments measuring parental sensitivity. Attach Hum Dev. 2013;15:485–506. doi: 10.1080/14616734.2013.820900. [PubMed] [CrossRef] [Google Scholar]
Hodges EA, Hughes SO, Hopkinson J, Fisher JO. Maternal decisions about the initiation and termination of infant feeding. Appetite. 2008;50:333–9. doi: 10.1016/j.appet.2007.08.010. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Ventura AK, Inamdar LB, Mennella JA. Consistency in infants’ behavioural signalling of satiation during bottle-feeding. Pediatr Obes. 2015;10:180–7. doi: 10.1111/ijpo.250. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Bentley ME, Wasser HM, Creed-Kanashiro HM. Responsive feeding and child undernutrition in low- and middle-income countries. J Nutr. 2011;141:502–7. doi: 10.3945/jn.110.130005. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Mentro AM, Steward DK, Garvin BJ. Infant feeding responsiveness: a conceptual analysis. J Adv Nurs. 2002;37:208–16. doi: 10.1046/j.1365-2648.2002.02068.x. [PubMed] [CrossRef] [Google Scholar]
McNally J, Hugh-Jones S, Caton S, Vereijken C, Weenen H, Hetherington M. Communicating hunger and satiation in the first 2 years of life: a systematic review. Matern Child Nutr. 2016;12:205–28. doi: 10.1111/mcn.12230. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Shloim N, Shafiq I, Blundell-Birtill P, Hetherington MM. Infant hunger and satiety cues during the first two years of life: developmental changes of within meal signalling. Appetite. 2018;128:303–10. doi: 10.1016/j.appet.2018.05.144. [PubMed] [CrossRef] [Google Scholar]
Shloim N, Vereijken CMJL, Blundell P, Hetherington MM. Looking for cues - infant communication of hunger and satiation during milk feeding. Appetite. 2017;108:74–82. doi: 10.1016/j.appet.2016.09.020. [PubMed] [CrossRef] [Google Scholar]
Fomon SJ, Filmer LJ, Thomas LN, Anderson TA, Nelson SE. Influence of formula concentration on caloric intake and growth of normal infants. Acta Paediatr Scand. 1975;64:172–81. doi: 10.1111/j.1651-2227.1975.tb03818.x. [PubMed] [CrossRef] [Google Scholar]
Fomon SJ, Filer LJ, Thomas LN, Rogers RR, Proksch AM. Relationship between formula concentration and rate of growth of normal infants. J Nutr. 1969;98:241–54. doi: 10.1093/jn/98.2.241. [PubMed] [CrossRef] [Google Scholar]
Ounsted M, Sleigh G, THE INFANT’S SELF-REGULATION OF, FOOD INTAKE AND WEIGHT GAIN The Lancet. 1975;305:1393–7. doi: 10.1016/S0140-6736(75)92605-7. [PubMed] [CrossRef] [Google Scholar]
Dewey KG, Lönnerdal B. Infant self-regulation of breast milk intake. Acta Paediatr Scand. 1986;75:893–8. doi: 10.1111/j.1651-2227.1986.tb10313.x. [PubMed] [CrossRef] [Google Scholar]
Daniels LA, Mallan KM, Battistutta D, Nicholson JM, Meedeniya JE, Bayer JK, et al. Child eating behavior outcomes of an early feeding intervention to reduce risk indicators for child obesity: the NOURISH RCT: child eating behavior outcomes of the NOURISH RCT. Obesity. 2014;22:E104–11. doi: 10.1002/oby.20693. [PubMed] [CrossRef] [Google Scholar]
Black MM, Hurley KM. Responsive feeding: strategies to promote healthy mealtime interactions. Nestle Nutr Inst Workshop Ser. 2017;87:153–65. doi: 10.1159/000448965. [PubMed] [CrossRef] [Google Scholar]
Gross RS, Fierman AH, Mendelsohn AL, Chiasson MA, Rosenberg TJ, Scheinmann R, et al. Maternal perceptions of infant hunger, satiety, and pressuring feeding styles in an urban Latina WIC population. Acad Pediatr. 2010;10:29–35. doi: 10.1016/j.acap.2009.08.001. [PubMed] [CrossRef] [Google Scholar]
Crow RA. An ethological study of the development of infant feeding. J Adv Nurs. 1977;2:99–109. doi: 10.1111/j.1365-2648.1977.tb00183.x. [PubMed] [CrossRef] [Google Scholar]
Hodges EA, Wasser HM, Colgan BK, Bentley ME. Development of feeding Cues during Infancy and Toddlerhood. MCN Am J Matern Child Nurs. 2016;41:244–51. doi: 10.1097/NMC.0000000000000251. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Hetherington MM. Understanding infant eating behaviour - Lessons learned from observation. Physiol Behav. 2017;176:117–24. doi: 10.1016/j.physbeh.2017.01.022. [PubMed] [CrossRef] [Google Scholar]
Beebe B, Stern DN. Engagement-Disengagement and early object experiences. In: Freedman N, Grand S, editors. Communicative structures and psychic structures. Boston, MA: Springer US; 1977. pp. 35–55. [Google Scholar]
de Lauzon-Guillain B, Oliveira A, Charles MA, Grammatikaki E, Jones L, Rigal N, et al. A review of methods to assess parental feeding Practices and Preschool Children’s eating behavior: the need for further development of tools. J Acad Nutr Dietetics. 2012;112:1578–1602e8. doi: 10.1016/j.jand.2012.06.356. [PubMed] [CrossRef] [Google Scholar]
DiSantis K, Hodges EA, Fisher J. The association of breastfeeding duration with later maternal feeding styles in infancy and toddlerhood: a cross-sectional analysis. Int J Behav Nutr Phys Act. 2013;10:53. doi: 10.1186/1479-5868-10-53. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Taveras EM, Scanlon KS, Birch L, Rifas-Shiman SL, Rich-Edwards JW, Gillman MW. Association of Breastfeeding with maternal control of infant feeding at Age 1 year. Pediatrics. 2004;114:e577–83. doi: 10.1542/peds.2004-0801. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Baughcum AE, Powers SW, Johnson SB, Chamberlin LA, Deeks CM, Jain A, et al. Maternal feeding Practices and Beliefs and their Relationships to overweight in early childhood. J Dev Behav Pediatr. 2001;22:391–408. doi: 10.1097/00004703-200112000-00007. [PubMed] [CrossRef] [Google Scholar]
Birch LL, Davison KK, FAMILY ENVIRONMENTAL FACTORS INFLUENCING THE DEVELOPING BEHAVIORAL, CONTROLS OF FOOD INTAKE AND CHILDHOOD OVERWEIGHT Pediatr Clin North Am. 2001;48:893–907. doi: 10.1016/S0031-3955(05)70347-3. [PubMed] [CrossRef] [Google Scholar]
Sherry B, McDivitt J, Birch LL, Cook FH, Sanders S, Prish JL, et al. Attitudes, practices, and concerns about child feeding and child weight status among socioeconomically diverse white, hispanic, and african-american mothers. J Am Diet Assoc. 2004;104:215–21. doi: 10.1016/j.jada.2003.11.012. [PubMed] [CrossRef] [Google Scholar]
Hughes SO, Power TG, Orlet Fisher J, Mueller S, Nicklas TA. Revisiting a neglected construct: parenting styles in a child-feeding context. Appetite. 2005;44:83–92. doi: 10.1016/j.appet.2004.08.007. [PubMed] [CrossRef] [Google Scholar]
Anderson AS, Guthrie CA, Alder EM, Forsyth S, Howie PW, Williams FL. Rattling the plate–reasons and rationales for early weaning. Health Educ Res. 2001;16:471–9. doi: 10.1093/her/16.4.471. [PubMed] [CrossRef] [Google Scholar]
Shloim N, Rudolf M, Feltbower RG, Mohebati L, Hetherington M. Breast is best: positive mealtime interactions in breastfeeding mothers from Israel and the United Kingdom. Health Psychol Open. 2015;2:2055102915579605. doi: 10.1177/2055102915579605. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Ursache A, Noble KG. The Pediatric Imaging, Neurocognition and Genetics Study. Socioeconomic status, white matter, and executive function in children. Brain Behav. 2016;6:e00531. doi: 10.1002/brb3.531. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Yichen L, Xiaozheng CH, Xiaorui SH, Hui H. Analysis of developmental screening and influencing factors of 2 980 infants under three months in Beijing. Beijing Med. 2022;44:513–7. [Google Scholar]
Morawska A, Sanders MR, editors., editors. Handbook of Parenting and Child Development Across the Lifespan. 1st ed. 2018. Cham: Springer International Publishing: Imprint: Springer; 2018.
Cartagena DC, Ameringer SW, McGrath J, Jallo N, Masho SW, Myers BJ. Factors contributing to infant overfeeding with hispanic mothers. J Obstet Gynecol Neonatal Nurs. 2014;43:139–59. doi: 10.1111/1552-6909.12279. [PubMed] [CrossRef] [Google Scholar]
Shloim N, Rudolf M, Feltbower R, Hetherington M. Adjusting to motherhood. The importance of BMI in predicting maternal well-being, eating behaviour and feeding practice within a cross cultural setting. Appetite. 2014;81:261–8. doi: 10.1016/j.appet.2014.06.011. [PubMed] [CrossRef] [Google Scholar]
Jinliuxing Y, Yue Z, Weiwei F, He T, Jie SH, Nianrong W, et al. Practice of parenting and related factorson children aged 0–5 in the urban areas of India. Chin J Epidemiol. 2019;40:422–6. [PubMed] [Google Scholar]
Zhang Y, Sanders M, Feng W, Tang H, Wang H, Jin X, et al. Using epidemiological data to identify needs for child-rearing support among indian parents: a cross-sectional survey of parents of children aged 6 to 35 months in 15 indian cities. BMC Public Health. 2019;19:1470. doi: 10.1186/s12889-019-7635-y. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Britton C, McCormick FM, Renfrew MJ, Wade A, King SE. Support for breastfeeding mothers.Cochrane Database Syst Rev. 2007;:CD001141. [PubMed]
Kuzela AL, Stifter CA, Worobey J. Breastfeeding and mother-infant interactions. J Reproductive Infant Psychol. 1990;8:185–94. doi: 10.1080/02646839008403623. [CrossRef] [Google Scholar]
Brown A, Arnott B. Breastfeeding duration and early parenting behaviour: the importance of an infant-led, responsive style. PLoS ONE. 2014;9:e83893. doi: 10.1371/journal.pone.0083893. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
. Singhal A, Kennedy K, Lanigan J, Fewtrell M, Cole TJ, Stephenson T, et al. Nutrition in infancy and long-term risk of obesity: evidence from 2 randomized controlled trials. Am J Clin Nutr. 2010;92:1133–44. doi: 10.3945/ajcn.2010.29302. [PubMed] [CrossRef] [Google Scholar]
Augustine JM. Mothers’ out-of-sequence Postsecondary Education and their Health and Health Behaviors. J Health Soc Behav. 2021;62:2–18. doi: 10.1177/0022146520979664. [PubMed] [CrossRef] [Google Scholar]
Zajacova A, Lawrence EM. The relationship between Education and Health: reducing disparities through a Contextual Approach. Annu Rev Public Health. 2018;39:273–89. doi: 10.1146/annurev-publhealth-031816-044628. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Mirowsky J, Ross CE. Education, social status, and health. New York: A. de Gruyter; 2003. [Google Scholar]
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