Looking for cues – infant communication of hunger and satiation during milk feeding

Abstract

Article:Shloim, N orcid.org/0000-0001-7548-5434, Vereijkan, CMJL, Blundell, P et al. It is known that duration of breastfeeding and responsive feeding are associated with decreased risk of obesity. It is however, not clear whether breastfed infants signal more to mothers to facilitate responsive feeding, compared to formula fed, nor what communication cues are important during the feeding interaction. The present study aimed to explore feeding cues in milk-fed infants and to examine if such cues vary by mode of feeding. Twenty-seven mothers and infants were filmed while breastfeeding or formula feeding. Infants' age ranged from 3-22 weeks. Feeding cues were identified using a validated list of communication cues (NCAST). The frequency of each cue during the beginning, middle, and end of the meal was recorded. There were 22 feeding cues identified during the feeds, with significantly more frequent disengagement cues expressed than engagement cues. Significantly more frequent feeding cues were observed at the beginning than at the end of the meal showing that cue frequency changes with satiation. Breastfeeding infants exhibited more engagement and disengagement cues than formula fed infants. Supporting mothers to identify engagement and disengagement cues during a milk feed may promote more responsive feeding-strategies that can be acquired by mothers using different modes of feeding. Introduction:

Bottle‐feeding an infant feeding modality: An integrative literature review

“…An infant's milk intake during feeding has a strong association to the interaction between the infant and parent/caregiver (Crow et al, ; Golen & Ventura, ; Shloim, Vereijken, Blundell, & Hetherington, ; Ventura & Golen, ; Ventura & Mennella, ; Ventura, Sheeper, & Levy, ; Wright, Fawcett, & Crow, ). Rybski, Almli, Gisel, Powers, and Maurer () found that a mother's interactions did not change over 24 hr, nor did they affect an infant's milk intake.…”

“…Studies that explored maternal responsiveness and infant feeding cues found that bottle‐feeding infants actively engage in and reciprocate responses of the mother allowing the infant to be an active participant in the feeding interaction (Ventura et al, ; Ventura & Mennella, ). However, breastfeeding infants were identified by Shloim et al () as displaying more cues of hunger and satiety than bottle‐feeding infants. Suggesting this is because of the infant being an active participant when breastfeeding and passive when bottle‐feeding.…”

“…Ventura et al () also used the Caregiver/Parent Child Interaction Feeding Scale, relying on two of the subscales—infant's clarity of cues and maternal sensitivity to cues for their study findings. Shloim et al () was the only study to explore infant communication without assessing the mother's response, possibly affecting her infant's cues during the feeding interaction. The authors cited the “Nursing Child Assessment Teaching Scale” as their basis for defining engagement and disengagement cues for hunger and satiety.…”

Understanding infant eating behaviour – Lessons learned from observation

“…Overall breastfed infants displayed more of both types of cue than formula fed, in particular, engagement cues such as sucking were more apparent at the beginning of a feed in breastfed compared to formula fed babies. Breastfed babies also opened their mouth and indicated greater readiness to eat at the beginning of the feed compared to formula fed infants (Shloim et al, 2017).…”

“…There is evidence that breastfeeding mothers are more responsive to their infants and in part, this could be due to the communication proficiency shown by breastfed babies (Shloim et al, 2017).…”