Understanding predictors of overfeeding during infant feeding

项目摘要/摘要 婴儿期体重的快速增加是预防肥胖努力和配方奶瓶的重要目标。 喂食被强调为最强的可修改的预测因素之一，可预测在以下情况下体重快速增加的风险 产后时期。目前的建议和预防计划旨在降低快速 儿童早期的体重增加和肥胖主要集中在促进反应性喂养上 无论采用何种牛奶类型或喂养方式，都应采取相应的做法。然而，如何推动的证据基础 奶瓶喂养过程中的反应性喂养很少，这主要是由于以前的方法限制 研究。允许检查母亲在两个乳房期间的喂养行为的受试者内研究 和奶瓶喂养，以阐明有针对性的初级预防工作的最有效目标。 拟议研究的目的是通过进行受试者内的研究来解决当前的研究差距， 40例母婴双胎的实验室实验研究 奶瓶和母乳喂养的相互作用。这种方法的优点是能够：1)隔离影响 喂养方式对喂养结果的影响；2)考虑母亲对婴儿暗示的敏感度的个体差异 缓和喂养方式对喂养结果的影响；以及3)控制可能 影响喂养决策和实践。为此，我们将客观地评估婴儿在 这两种喂奶方式是在喂奶前和喂奶后称婴儿体重。我们还将录制视频 喂养观察，以允许对母亲对婴儿暗示的敏感性和婴儿对 使用护理儿童评估亲子互动喂养量表(NCAFS)的线索，并将放置 母亲和婴儿的心电图均可用于评估行为和生理的同步性。 在进食过程中相互作用。这些数据将用于实现以下具体目标：目标1：审查 母亲对婴儿暗示的敏感性是否缓和了喂养方式对婴儿摄入量的影响；目标2： 确定母亲对婴儿暗示的低敏感性的关键预测因素；探索性目标：检查 母婴行为和生理的同步性在奶瓶喂养和母乳喂养之间是不同的。 这项创新的研究将为喂养方式和母亲的喂养实践提供新的见解 相互作用影响婴儿喂养结果，并将为进一步研究创造重要基础 与婴儿早期肥胖的初级预防有关。

PROJECT SUMMARY/ABSTRACT Rapid weight gain during infancy is an important target for obesity prevention efforts and formula-/bottle- feeding has been highlighted as one of the strongest modifiable predictors of risk for rapid weight gain during the postpartum period. Current recommendations and prevention programs aimed at reducing risk for rapid weight gain and obesity during early childhood have predominately focused on promoting responsive feeding practices, regardless of milk type or feeding mode used. However, the evidence-base for how to promote responsive feeding during bottle-feeding is scant, primarily due to methodological limitations of previous research. Within-subject studies that allow for examination of mothers' feeding practices during both breast and bottle-feeding are needed to elucidate the most effective targets for tailored primary prevention efforts. The aim of the proposed research is to address current research gaps by conducting a within-subject, laboratory-based experimental study of 40 mother-infant dyads wherein we will observe dyads during both bottle- and breastfeeding interactions. Strengths of this approach will be the ability to: 1) isolate effects of feeding mode on feeding outcomes; 2) consider how individual differences in maternal sensitivity to infant cues moderates effects of feeding mode on feeding outcomes; and 3) control for unmeasured covariates that may influence both feeding decisions and practices. To this end, we will objectively assess infant intake during these two modes of feeding by weighing the baby before and after the feeding. We will also video-record feeding observations to allow for behavioral coding of maternal sensitivity to infant cues and infant clarity of cues using the Nursing Child Assessment Parent-Child Interaction Feeding Scale (NCAFS), and will place electrocardiogram (ECG) leads on both mothers and infants to assess behavioral and physiological synchrony during feeding interactions. These data will be used to address the following specific aims: Aim 1: To examine whether maternal sensitivity to infant cues moderates effects of feeding mode on infant intake; Aim 2: To identify key predictors of low maternal sensitivity to infant cues; Exploratory Aim: To examine whether maternal-infant behavioral and physiological synchrony differs between bottle-feeding versus breastfeeding. This innovative study will provide novel insights related to how feeding mode and mothers' feeding practices interact to influence infant feeding outcomes and will create an important foundation for further research related to the primary prevention of obesity during early infancy.