Understanding predictors of overfeeding during infant feeding

项目总结/摘要 婴儿期体重快速增加是肥胖预防工作的重要目标， 喂养已被强调为快速体重增加风险的最强可改变的预测因素之一， 产后时期。目前的建议和预防计划旨在降低风险的快速 儿童早期的体重增加和肥胖主要集中在促进反应性喂养 实践中，无论牛奶类型或喂养模式使用。然而，如何促进的证据基础 奶瓶喂养期间的反应性喂养很少，主要是由于以前的方法学限制。 research.受试者内研究，允许检查母亲在两个乳房期间的喂养习惯 和奶瓶喂养，以阐明最有效的目标，有针对性的初级预防工作。 拟议研究的目的是通过进行一项主题内， 一项基于实验室的40对母婴的实验研究，我们将在两个阶段观察母婴 奶瓶和母乳喂养的相互作用。这种方法的优势在于能够：1）隔离 喂养方式对喂养结果的影响; 2）考虑母亲对婴儿线索敏感性的个体差异 喂养方式对喂养结果的影响; 3）控制未测量的协变量， 影响喂养决策和实践。为此，我们将客观评估婴儿摄入量， 这两种喂养方式都是通过称量婴儿喂养前后的体重来实现的。我们还将录像 喂养观察，以允许母亲对婴儿线索的敏感性和婴儿的清晰度的行为编码。 提示使用护理儿童评估亲子互动喂养量表（NCAFS），并将放置 母亲和婴儿的心电图（ECG）导联，以评估行为和生理同步性 在进食互动中。这些数据将用于实现以下具体目标： 母亲对婴儿线索的敏感性是否会调节喂养方式对婴儿摄入量的影响;目的2： 确定母亲对婴儿线索敏感性低的关键预测因素;探索性目的：研究是否 母乳喂养与奶瓶喂养之间的母婴行为和生理同步性不同。 这项创新的研究将提供新的见解有关喂养模式和母亲的喂养做法 相互作用，影响婴儿喂养结果，并将为进一步研究奠定重要基础 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.