CORRELATES OF PRETERM AND TERM INFANT FEEDING OUTCOMES

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DESCRIPTION: (Adapted from applicant's abstract) The proposed study: (a) describes, compares, and contrasts feeding outcomes (dietary intake, somatic growth, and developmental status) for two groups of infants (very low birthweight, preterm infants with a history of pulmonary problems and healthy fullterm infants) through the first year post term; and (b) examines the effect of maternal and infant feeding behavior on these outcomes. For each of four study times, relationships are examined among: (1) maternal characteristics (age, marital status, education, parenting stress, and depressive symptoms) and infant characteristics (maturity at birth-gestational age, respiratory status, and weight) with maternal feeding behavior; and (2) infant characteristics, maternal and infant feeding behavior, and feeding outcomes. Change in relationships over time is examined, and differences between the two groups of infants in relationships will be explored. The longitudinal study uses a repeated measures design. Data are collected at home visits made at one, four, eight and twelve months post-term. The convenience sample includes 50-60 mothers and their infants in each of the two groups. Mothers' parenting stress is examined with Abidin's Parenting Stress Index, and depressive symptoms are measured with the CES-D Scale. The infant's respiratory status is assessed in the neonatal period using the computerized system developed by Farrell and Palta and at each of the four study times with observation of respiratory effort, pulse oximetry, and maternal report of supplemental oxygen requirement. Maternal and infant feeding behavior will be examined with the observer rating scales of the Parent-Child Early Relational Assessment. Dietary intake is measured in terms of calories/kg and g protein/kg body weight. Somatic growth is measured by rate of weight gain/day (g) and of growth in length/day (mm). Developmental status is assessed at twelve months with the Bayley Mental and Motor Scales of Infant Development and at eight and twelve months with measures of information-processing competence (visual attention). Multivariate analysis of variance (MANOVA) is used for study of repeated measures. Polynomial regression will be used to study rate of growth in weight and length over time. Multiple regression of sets of independent variables will be used to examine relationships among variables. The effect of time-dependent covariates (parenting stress, depressive symptoms, and infant respiratory status and weight) are estimated with a quasi-likelihood model. Hypothesized relationships among variables will be examined with general linear multivariate models. Estimates of the group specific standardized regression