The Development of Eating Behavior in Infancy: Associations with Behavior, Diet, and Growth to Age 6 years

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PROJECT SUMMARY Eating behaviors are robustly associated with dietary quality and weight gain. Given the relevance of eating behaviors to health in children and adults, remarkably little is known regarding the development of these behaviors from infancy, and their continuity (or discontinuity) into childhood. Eating behaviors can be phenotyped in infancy through rigorous measurement of behavior following exposure to different stimuli under careful experimental control, though no studies prior to R01HD084163 have phenotyped multiple eating behaviors objectively in a single longitudinal infant cohort. Eating behavior may be modifiable between infancy and early childhood, potentially altering any associations with future dietary quality or weight gain. Interventions that promote adaptive maternal feeding practices have been effective in reducing obesity risk. Intervention effects might be further strengthened by tailoring to characteristics of the individual child. Identifying interactions of carefully phenotyped child eating behavior and maternal feeding practices in an observational cohort study is an important initial step towards future tailored intervention development. The proposed work will examine for the first time the continuity (or discontinuity) of extensively phenotyped eating behaviors in infancy, based on novel objective measures and maternal report, to age 5 years. The work will, for the first time, test whether maternal feeding practices and infant eating behaviors interact to predict child eating behaviors at age 5 years, as well as dietary quality and BMI at age 6 years. The ABC Baby study (R01HD084163, 7/1/15-06/30/20) and its ancillary funded studies used novel behavioral protocols to phenotype eating behavior and maternal feeding practices longitudinally at ages 2 weeks, and 2, 4, 6, 9, and 12 months in a cohort of 286 infants. The current application proposes to follow up with 200 of these children at ages 5 and 6 years to address the following aims: Aim 1: To test the cross-lagged associations between child eating behaviors and maternal feeding practices across infancy and age 5 years. We hypothesize that child eating behaviors in infancy predict child eating behaviors at age 5 years, maternal feeding practices in infancy predict maternal feeding practices at age 5 years, child eating behaviors in infancy predict maternal feeding practices at 5 years, and maternal feeding practices in infancy predict child eating behaviors at 5 years. Aim 2: To test the hypothesis that eating behaviors measured in infancy have direct and indirect (through eating behaviors at age 5 years) associations with dietary quality and BMI at age 6 years. Aim 3: To test the hypotheses that maternal feeding practices in infancy moderate associations of infant eating behaviors with eating behaviors at 5 years, and that maternal feeding practices at 5 years moderate associations of eating behaviors in infancy with dietary quality and BMI at age 6 years, and moderate associations of eating behaviors at age 5 years with dietary quality and BMI at age 6 years.