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

项目摘要/摘要 婴儿期体重快速增加被认为是预防和干预努力的主要目标。 配方奶/奶瓶喂养已被强调为快速感染风险的最强可修改预测因素之一。 产后体重增加。目前的建议和预防方案旨在 减少儿童早期体重快速增加和肥胖的风险主要集中在 促进响应的喂养实践，无论使用何种牛奶类型或喂养方式。但是，以前的 检查响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 喂养方式和方式对婴儿结局的影响，而没有充分考虑婴儿的行为 作为有效沟通饱腹感的能力--可能会影响摄食相互作用。并矢元的研究 在更广泛的婴儿发育研究领域，相互作用是常见的，但明显缺乏 婴儿喂养领域的研究试图客观地描述在喂养过程中的二元相互作用 研究婴儿和母亲对喂养互动的贡献。 这项拟议研究的目的是通过描述婴儿的共同发展来解决这一研究差距。 在婴儿期和喂养环境中传达饱腹感和母亲的喂养做法。男女同居者是 目前正在进行ABC婴儿研究，这是由NICHD资助(R01HD084163)的前瞻性纵向研究 在婴儿2周、2个月、4个月、6个月、9个月和12个月时，对325对母婴进行了评估。整体而言 ABC婴儿研究的目的是描述婴儿的发育轨迹与 食欲驱使和体重增加。这项研究的一个独特之处是，所有的双星都是在 每次评估时的自然瓶子喂养交互作用和6、9和12次的固体食物喂养交互作用 月份。然而，对视频进行行为编码并不是父母拨款目标的一部分。在建议的研究中，我们 目的增加新的、客观的婴儿饱腹感和母体反应性沟通措施，以 喂养过程中的婴儿提示，以允许进行创新的调查，这将为未来-也是迫切需要的-提供信息 初级预防工作。将现有的研究数据与拟议的 研究，我们的目标是：1)描述在2周和2，4，6， 9个月和12个月，并识别出表现出明显的二元摄食发展轨迹的二元体簇 跨婴儿期的相互作用；2)检查集群成员和快速体重风险之间的关联 从出生到12个月之间的增长；以及3)确定集群成员的母婴相关因素。 这项拟议研究的结果将突出可修改的机制 母婴风险因素和婴儿结局，这将有助于制定有针对性的预防措施 最适合高风险二人组需求的方案。

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.