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Zhao F, Sun Y, Zhang Y, Xu T, Wang N, Yan S, Zeng T, Zhang F, Gao J, Yue Q, Rozelle S. Comparison of mothers' perceptions of hunger cues in 3-month-old infant under different feeding methods. BMC Public Health 2023; 23:444. [PMID: 36882770 PMCID: PMC9993530 DOI: 10.1186/s12889-023-15325-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023] Open
Abstract
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 China, especially lacking the studies on perceptions of infant hunger cues. Consider the cultural differences, the aim of this study was to describe the perceptions of infant hunger cues of Chinese mothers for infants aged 3 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 326 mothers of healthy 3-month-old infants, including 188 exclusive breastfeeding (EBF) mothers and 138 formula feeding (FF) mothers. It was implemented in four provincial and municipal maternal and child health hospitals. The mothers' perceptions of infant hunger cues were surveyed by self-reporting questionnaires. Chi-square tests and logistic analysis were applied to analyze the differences in maternal perceptions of infant hunger cues, including the number of hunger cues and the specific cues, between EBF group and FF group by controlling sociodemographic variables and the daily nursing indicators. RESULTS We found that a higher proportion of EBF mothers could perceive multiple hunger cues (≥ 2) than FF mothers (66.5% vs.55.1%). For specific cues, the EBF mothers had higher perceptions of infant's "hand sucking" (67.6% vs. 53.6%) and "moving head frantically from side to side" (34.6% vs. 23.9%), all p < 0.05. Regression analysis 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 3-month-old infants may be more likely to perceive infant hunger cues than FF mothers in China. It is necessary to increase the health education about infant hunger and satiety cues to caregivers in China, especially among mothers with lower education levels, mothers living in nuclear families, and FF mothers.
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Affiliation(s)
- Fenghua Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Yijie Sun
- Qingdao Maternal and Child Health and Family Planning Service Center, Shandong, 266072, China
| | - Yue Zhang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China.
| | - Tao Xu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Nianrong Wang
- Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Shuangqin Yan
- Ma'anshan Maternal and Child Health Hospital, Anhui, 243011, China
| | - Ting Zeng
- Liuzhou Maternity and Child Healthcare Hospital, Guangxi, 545001, China
| | - Fenghua Zhang
- Qingdao Maternal and Child Health and Family Planning Service Center, Shandong, 266072, China
| | - Jie Gao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Qing Yue
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, 100081, China
| | - Scott Rozelle
- Stanford University Freeman Spogli Institute for International Studies, Stanford, CA, 94305-6055, USA
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Redsell SA, Slater V, Rose J, Olander EK, Matvienko-Sikar K. Barriers and enablers to caregivers' responsive feeding behaviour: A systematic review to inform childhood obesity prevention. Obes Rev 2021; 22:e13228. [PMID: 33779040 DOI: 10.1111/obr.13228] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/18/2021] [Accepted: 02/06/2021] [Indexed: 12/12/2022]
Abstract
Responsive infant feeding is a critical component of childhood obesity prevention. However, there is little guidance for caregivers on how to do this successfully. The first step to developing an intervention to promote responsive feeding is to systematically identify its barriers and enablers. Searches were conducted in CINAHL, Cochrane Library, Medline, Embase, PubMed, PsycINFO, Maternity, and Infant Care from inception to November 2020. All study designs were included if they reported a barrier or enabler to responsive feeding during the first 2 years of life. We used a "best fit" framework synthesis, with the Capacity, Opportunity, Motivation, and Behaviour (COM-B) model. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality. Forty-three studies were included in the review. Barriers (n = 36) and enablers (n = 21) were identified across five COM-B domains: psychological capacity, physical and social opportunity, and reflective and automatic motivation. Enablers were recognition of infant feeding cues, feeding knowledge and family and friends. Caregiver attitude toward control of feeding was a barrier, together with health care professional advice about formula feeding and breastfeeding expectation. These barriers and enablers provide a comprehensive evidence base to guide intervention development to improve responsive feeding and prevent obesity across individual and population levels.
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Affiliation(s)
- Sarah A Redsell
- School of Health Sciences, University of Nottingham, B302, Medical School Building, Queens Medical Centre, Nottingham, NG7 2UH, UK
| | - Vicki Slater
- Faculty of Health Social Care, Education and Medicine, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK
| | - Jennie Rose
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK.,Ely Primary Care Networks, Staploe Medical Centre, Brewhouse Lane, Soham, UK
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, EC1V 0HB, UK
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Kilvington A, Barnaba C, Rajasekaran S, Laurens Leimanis ML, Medina-Meza IG. Lipid profiling and dietary assessment of infant formulas reveal high intakes of major cholesterol oxidative product (7-ketocholesterol). Food Chem 2021; 354:129529. [PMID: 33761334 DOI: 10.1016/j.foodchem.2021.129529] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/03/2021] [Accepted: 03/02/2021] [Indexed: 12/17/2022]
Abstract
Approximately two-thirds of US infants receive infant formula (IF) as a primary or sole nutritional source during the first six months of life. IF is available in a variety of commercial presentations; from a manufacturing standpoint, they can be categorized as powder- (PIF) or liquid- (LIF) based formulations. Thirty commercial IFs were analyzed in their oxidative and non-oxidative lipid profiles. We identified 7-ketocholesterol - a major end-product of cholesterol oxidation - as a potential biomarker of IF manufacturing. The statistical analysis allowed a re-classification of IF based on their metabolomic fingerprint, resulting in three groups assigned with low-to-high oxidative status. Finally, we modeled the dietary intake of cholesterol, sterols, and 7-ketocholesterol in the first year of life. The database provided in this study will be instrumental for scientists interested in infant nutrition, to establish bases for epidemiological studies aimed to find connections between nutrition and diet-associated diseases, such as sitosterolemia.
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Affiliation(s)
- Alice Kilvington
- Department of Chemical Engineering and Materials Science, Michigan State University, East Lansing, MI, USA.
| | - Carlo Barnaba
- Institute of Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA.
| | - Surender Rajasekaran
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, USA; Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
| | - Mara L Laurens Leimanis
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, USA; Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
| | - Ilce G Medina-Meza
- Department of Chemical Engineering and Materials Science, Michigan State University, East Lansing, MI, USA; Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA.
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Responsive Feeding, Infant Growth, and Postpartum Depressive Symptoms During 3 Months Postpartum. Nutrients 2020; 12:nu12061766. [PMID: 32545540 PMCID: PMC7353384 DOI: 10.3390/nu12061766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/29/2020] [Accepted: 06/09/2020] [Indexed: 12/01/2022] Open
Abstract
Responsive feeding is crucial to the formation of life-long healthy eating behavior. Few studies have examined maternal responsive feeding in early infancy among a Chinese population. This prospective study describes maternal responsive feeding and factors associated with maternal responsive feeding, with emphasis on infant growth and maternal depressive symptoms, during the first 3 months postpartum in Taiwan. From 2015 to 2017, 438 pregnant women were recruited and followed at 1 and 3 months postpartum. Maternal responsive feeding at 3 months was measured on a 10-item 5-point Likert-type scale. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale with a cutoff score of 10. Infant growth was categorized into four groups based on weight-for-length Z scores from birth to 3 months: no change, increase but in the normal range, increase to overweight, and decrease to underweight. Multiple regression revealed that postpartum depressive symptoms, primipara, and decreased infant weight-for-length Z score were negatively associated with maternal responsive feeding, while exclusive breastfeeding and maternal age younger than 29 years were positively associated with maternal responsive feeding. Heath professionals should educate mothers on responsive feeding, with emphases on first-time and non-exclusive breastfeeding mothers, as well as those with depressive symptoms, advanced maternal age, and infants who are becoming underweight.
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Slater V, Rose J, Olander E, Matvienko-Sikar K, Redsell S. Barriers and enablers to Caregivers Responsive feeding Behaviour (CRiB): A mixed method systematic review protocol. HRB Open Res 2020; 3:2. [PMID: 32715274 PMCID: PMC7333359 DOI: 10.12688/hrbopenres.12980.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Childhood overweight and obesity is a major public health issue. Responsive feeding has been identified as having a protective effect against child overweight and obesity, and is associated with healthy weight gain during infancy. Responsive feeding occurs when the caregiver recognises and responds in a timely and developmentally appropriate manner to infant hunger and satiety cues. Despite its benefits, responsive feeding is not ubiquitous. To better support caregivers to engage in responsive feeding behaviours, it is necessary to first systematically identify the barriers and enablers associated with this behaviour. This mixed-methods systematic review therefore aims to synthesise evidence on barriers and enablers to responsive feeding using the COM-B model of behavioural change. Methods: 7 electronic databases will be searched (Maternal and Infant Care, CINAHL, Cochrane, PubMed, Medline, PsycINFO, EMBASE). Studies examining factors associated with parental responsive and non-responsive feeding of infants and children (<2 years) will be included. Papers collecting primary data, or analysing primary data through secondary analysis will be included. All titles, abstracts and full texts will be screened by two reviewers. Quantitative and qualitative data from all eligible papers will be independently extracted by at least two reviewers using pre-determined standardised data extraction forms. Two reviewers will independently assess the methodological quality of the studies using the Mixed Methods Appraisal Tool (MMAT). This review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA). Ethics and dissemination: Ethical approval is not required for this review as no primary data will be collected, and no identifying personal information will be present. The review will be disseminated in a peer reviewed journal. PROSPERO registration: CRD42019144570 (06/08/2019).
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Affiliation(s)
- Vicki Slater
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Jennie Rose
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ellinor Olander
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
| | | | - Sarah Redsell
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 1PT, UK
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Slater V, Rose J, Olander E, Matvienko-Sikar K, Redsell S. Barriers and enablers to Caregivers Responsive feeding Behaviour (CRiB): A mixed method systematic review protocol. HRB Open Res 2020; 3:2. [PMID: 32715274 PMCID: PMC7333359 DOI: 10.12688/hrbopenres.12980.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2020] [Indexed: 03/30/2024] Open
Abstract
Background: Childhood overweight and obesity is a major public health issue. Responsive feeding has been identified as having a protective effect against child overweight and obesity, and is associated with healthy weight gain during infancy. Responsive feeding occurs when the caregiver recognises and responds in a timely and developmentally appropriate manner to infant hunger and satiety cues. Despite its benefits, responsive feeding is not ubiquitous. To better support caregivers to engage in responsive feeding behaviours, it is necessary to first systematically identify the barriers and enablers associated with this behaviour. This mixed-methods systematic review therefore aims to synthesise evidence on barriers and enablers to responsive feeding using the COM-B model of behavioural change. Methods: 7 electronic databases will be searched (Maternal and Infant Care, CINAHL, Cochrane, PubMed, Medline, PsycINFO, EMBASE). Studies examining factors associated with parental responsive and non-responsive feeding of infants and children (<2 years) will be included. Papers collecting primary data, or analysing primary data through secondary analysis will be included. All titles, abstracts and full texts will be screened by two reviewers. Quantitative and qualitative data from all eligible papers will be independently extracted by at least two reviewers using pre-determined standardised data extraction forms. Two reviewers will independently assess the methodological quality of the studies using the Mixed Methods Appraisal Tool (MMAT). This review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA). Ethics and dissemination: Ethical approval is not required for this review as no primary data will be collected, and no identifying personal information will be present. The review will be disseminated in a peer reviewed journal. PROSPERO registration: CRD42019144570 (06/08/2019).
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Affiliation(s)
- Vicki Slater
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Jennie Rose
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ellinor Olander
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
| | | | - Sarah Redsell
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, CB1 1PT, UK
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7
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Maternal executive function and the family food environment. Appetite 2019; 137:21-26. [DOI: 10.1016/j.appet.2019.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/07/2019] [Accepted: 02/10/2019] [Indexed: 02/03/2023]
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Khatiwada A, Shoaibi A, Neelon B, Emond JA, Benjamin Neelon SE. Household chaos during infancy and infant weight status at 12 months. Pediatr Obes 2018; 13:607-613. [PMID: 30019385 PMCID: PMC6300983 DOI: 10.1111/ijpo.12395] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/09/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Infancy is a critical period for obesity prevention. Emerging evidence links household chaos to poor health outcomes, yet its impact on obesity in infancy is unknown. OBJECTIVES We examined associations between household chaos when infants were 6 and 12 months and weight-for-length (WFL) z-score at 12 months, exploring potential mediation by infant sleep and screen time. METHODS We examined 401 predominately Black women and infants in the southeastern United States. We conducted multivariable linear regressions examining household chaos and infant WFL z-score, assessing breastfeeding, sleep, screen time as potential mediators. RESULTS Among infants, 69.7% were Black and 49.0% were female. Mean breasting duration was 3.7 months. Over half (50.4%) of families had annual household incomes <$20 000. After adjustment for potential confounders, household chaos was associated with infant WFL z-score (0.02; 95% CI 0.001, 0.04; p = 0.04) at 12 months. We did not observe associations between chaos and infant breastfeeding, sleep or screen time. CONCLUSIONS Higher household chaos was associated with greater infant weight at 12 months, but there was no evidence of mediation by breastfeeding, sleep or screen time.
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Affiliation(s)
- Aastha Khatiwada
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina 29425
| | - Azza Shoaibi
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina 29425
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina 29425
| | - Jennifer A Emond
- Department of Biomedical Data Science, Dartmouth Geisel School of Medicine, Hanover, New Hampshire 03755
| | - Sara E Benjamin Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
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