Developmental trajectories of dyadic feeding interactions during infancy and their association with rapid weight gain

项目总结/摘要 婴儿期体重迅速增加已被认为是预防和干预工作的主要目标 配方奶/奶瓶喂养被强调为快速肥胖风险的最强可改变的预测因素之一。 产后期间体重增加。目前的建议和预防方案， 降低儿童早期体重快速增加和肥胖的风险主要集中在 促进响应喂养实践，无论牛奶类型或喂养模式使用。但此前的 研究反应性喂养的研究采取了以母亲为中心的方法，重点是将母亲的 喂养的做法和风格，以婴儿的结果没有充分考虑如何婴儿的行为-如 因为有效沟通饱腹感的能力可能影响进食的相互作用。并矢研究 在婴儿发育的更广泛的研究领域中，相互作用是常见的，然而， 婴儿喂养领域内的研究试图客观地描述喂养期间的二元相互作用， 研究婴儿和母亲对喂养互动的贡献。 本研究的目的是通过描述婴儿的共同发展来填补这一研究空白。 在婴儿期和喂养环境中沟通饱食和母亲的喂养做法。Co-I是 目前正在进行ABC婴儿研究，这是一项由NICHD（R 01 HD 084163）资助的前瞻性纵向研究 在婴儿2周和2、4、6、9和12个月时评估的325对母婴配对中，整体 ABC婴儿研究的目的是描述婴儿的发育轨迹之间的关联， 食欲和体重增加。这项研究的一个独特之处是，所有的二人组都是在 每次评估时的自然奶瓶喂养相互作用和6、9和12时的固体食物喂养相互作用 个月然而，视频的行为编码并不是父母资助目标的一部分。在这项研究中，我们 旨在增加新的，客观的措施，婴儿沟通的饱足感和母亲的反应， 婴儿在喂养过程中的线索，以允许一个创新的调查，将告知未来-和急需- 一级预防工作。通过将现有的研究数据与拟议中收集的新数据相结合， 研究，我们的目标是：1）描述在喂养2周期间发生的二元相互作用，以及2，4，6， 9，和12个月，并确定集群的二对谁显示出不同的发展轨迹的二对喂养 婴儿期的相互作用; 2）检查集群成员资格和快速体重风险之间的关联 出生和12个月之间的增益;和3）确定母体和婴儿相关的聚类成员。 拟议研究的结果将强调以下因素之间关联的可修改机制： 母婴风险因素和婴儿结局，这将为设计有针对性的预防措施提供信息 最适合高风险二人组需要的项目

PROJECT SUMMARY/ABSTRACT Rapid weight gain during infancy has been recognized as a prime target for prevention and intervention 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, previous research examining responsive feeding has taken a mother-centric approach, focusing on relating mothers' feeding practices and styles to infant outcomes without adequate consideration of how infant behaviors – such as ability to effectively communicate satiation – may influence feeding interactions. The study of dyadic interactions is common within the broader field of research on infant development, yet a marked paucity of research within the field of infant feeding attempts to objectively describe dyadic interactions during feeding to examine what both infants and mothers contribute to feeding interactions. The aim of the proposed research is to address this research gap by describing the co-development of infant communication of satiation and mothers' feeding practices across infancy and feeding contexts. The Co-Is are currently conducting the ABC Baby Study, an NICHD-funded (R01HD084163) prospective, longitudinal study of 325 mother-infant dyads assessed when infants were 2 weeks and 2, 4, 6, 9, and 12 months. The overall objective of the ABC Baby Study is to describe associations between developmental trajectories of infants' appetitive drives and weight gain. A unique feature of this study is that all dyads are video-recorded during naturalistic bottle-feeding interactions at each assessment and solid food feeding interactions at 6, 9, and 12 months. Yet, behavioral coding of the videos was not part of the parent grant aims. In the proposed study, we aim to add novel, objective measures of infant communication of satiation and maternal responsiveness to infant cues during feeding to allow for an innovative investigation that will inform future - and much needed – primary prevention efforts. By combining existing study data with the novel data collected in the proposed research, we will aim to: 1) describe the dyadic interactions that occur during feeding at 2 weeks, and 2, 4, 6, 9, and 12 months and identify clusters of dyads who show distinct developmental trajectories of dyadic feeding interactions across infancy; 2) examine associations between cluster membership and risk for rapid weight gain between birth and 12 months; and 3) identify maternal and infant correlates of cluster membership. Findings from the proposed research will highlight modifiable mechanisms underlying associations between maternal-infant risk factors and infant outcomes, which will inform efforts to design tailored prevention programs best-fit to the needs of high-risk dyads.