Mother-infant feeding interaction in full-term small-for-gestational-age infants

doi:10.1016/S0022-3476(88)80141-0

The Journal of Pediatrics

Volume 112, Issue 1, January 1988, Pages 143-148

https://doi.org/10.1016/S0022-3476(88)80141-0 Get rights and content

Maternal and infant behavior during feeding was assessed in 30 mother-infant dyads: 15 small-for-gestational-age (SGA) infants (birth weights below the 10th percentile) and 15 appropriate-for-gestational-age (AGA) infants (birth weights between the 25th and 90th percentiles). The groups were balanced for gestational age, sex, neonatal risk factors, and maternal age, parity, socioeconomic status, and race. Behaviors indicative of infant feeding difficultles were coded for mother and infant. The SGA mothers had higher frequencies of these behaviors than did their AGA counterparts. Qualitative ratings of interactive behavior were recorded for mother and infant: SGA infants had ratings indicative of less optimal interactions than those of the AGA group. Infant caloric intake (calories per kilogram per feeding) was calculated by first dividing the change in infant weight in grams before feeding and immediately after feeding by the infant's weight before feeding and then converting it to calories. Although no difference in caloric intake was observed between the two groups, infant behaviors and ratings were associated with caloric intake. These data suggest the importance of including neonatal behavior during feeding in the risk assessment of potential growth failure in SGA infants.

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Citation Excerpt :
Poor mother–infant interactions, characterized by maternal intrusiveness and negative infant engagement have been described for children born small for gestational age (SGA) (Feldman & Eidelman, 2006). Mothers of SGA infants also have higher frequency of behaviors indicative of feeding difficulties than their appropriate for gestational age counterparts (Mullen, Coll, Vohr, Muriel, & Oh, 1988). Therefore IUGR children may suffer from a double burden of vulnerability in terms of feeding modulation: their metabolic adaptations lead to persistent programming of appetite, food preferences (Ayres et al., 2012; Barbieri et al., 2009; Crume et al., 2013; Kaseva et al., 2013; Lussana et al., 2008; Migraine et al., 2013; Perala et al., 2012; Silveira et al., 2012; Stein et al., 2009) and chronic adult disease risk (Barker et al., 1989; Bettiol et al., 2007; Hales et al., 1991; Ravelli et al., 1976); in addition, their mother–infant relationship may affect feeding behaviors and long-term overweight risk.
Background/Objectives: While most “fetal programming” area focused on metabolic disease, intrauterine growth restriction (IUGR) is also associated with a preference for less healthy food. Post-natal factors such as strained maternal–child interactions are equally related to obesogenic eating behaviors. We investigated if IUGR and the quality of the mother/child relationship affect emotional overeating in children. Subjects/Methods: Participants were 196 children from a prospective birth cohort (the MAVAN project). As part of the protocol at 4 years of age, mothers completed the Children Eating Behavior Questionnaire (CEBQ) and mother–child interactions were scored during a structured task. A GLM adjusted for BMI examined the interaction between the “Atmosphere” score (ATM) task, sex and IUGR on the emotional over-eating domain of the CEBQ. Results: There was a significant interaction of BWR vs. sex vs. ATM (P = .02), with no effects of IUGR, sex or ATM. The model was significant for girls with low ATM scores (B = −2.035, P = .014), but not for girls with high (P = 0.94) or boys with high (P = .27) or low (P = .19) ATM scores. Only in IUGR girls, 48 months emotional over-eating correlated with BMI at that age (r = 0.560, P = 0.013) and predicted BMI in the subsequent years (r = 0.654, P = 0.006 at 60 months and r = 0.750, P = 0.005 at 72 months). Conclusions: IUGR and exposure to a negative emotional atmosphere during maternal–child interactions predicted emotional overeating in girls but not in boys. The quality of mother–infant interaction may be an important target for interventions to prevent emotional overeating and overweight in early development, particularly in girls with a history of IUGR.
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This study examined the contribution of infant temperament and mothers' play behaviors to the mental development of 40 small-for-gestational-age (SGA) and 32 appropriate-for-gestational-age (AGA) infants. Infant temperament and infant–caregiver interactions in a play and teaching session were assessed at 8 months, and infant mental development was assessed at 12 and 18 months of age. Few group differences emerged in temperament or mothers' behaviors, and no significant differences were found in infants' mental development at 12 or 18 months of age. Temperament and mothers' play behaviors showed distinct patterns of association with infants' mental development within each group. For the SGA infants, reciprocal play and mothers' play quality moderated the relation between infant mental development at 12 months of age and temperament. Within the AGA group, temperament and mothers' play behaviors demonstrated direct effects on infants' mental development. The results are discussed in terms of a transactional model of development.
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^*: Supported in part by Grant 5-T32-HD07232-05 (“Training in Perinatal Biology”).

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Mother-infant feeding interaction in full-term small-for-gestational-age infants*

J Pediatr

Early Hum Dev

The small-for-date infant. I. Later growth patterns

Pediatrics

Growth and development of full-term nonasphyxiated small-for-gestational age newborns: follow-up through adolescence

Pediatrics

Growth and development of twins dissimilar in size at birth

N Engl J Med

Born too soon or born too small

Intrauterine growth retardation

Observations of postnatal developmental activity in infants with fetal malnutrition

J Genet Psychol

Effects of atypical patterns of fetal growth on newborn (NBAS) behavior