Mothers' Assessment of Hunger in Relation to Meal Size in Breastfed Infants

Correlation between maternal eating disorder and early infant feeding regulation: a cross -sectional study

Background

The post-partum period is a vulnerable time for mothers in terms of eating disorder symptoms and is critical for the establishment of feeding patterns in infants. This study aimed to investigate the relationships between maternal eating disorder symptoms and objective indices of feeding regulation at 3 months, as well as perceived breastfeeding self-efficacy.

Methods

A sample of n = 73 full-term mother-child dyads (44% female) participated in the study. Mothers self-reported eating disorder symptoms and breastfeeding self-efficacy and objective indices of infant feeding regulation were obtained in the home.

Results

Findings revealed the existence of relationships between higher maternal eating disorder symptoms, and objective indices of infant feeding regulation with substantial gender differences in the patterns emerging. Among mother-daughter dyads, maternal weight and shape concerns were associated with higher infant transfer volume and rate during bottle feeding. In contrast, among mother-son dyads, higher maternal eating disorder symptoms, including weight, shape, and eating concern, were associated with lower infant transfer volume and rate as well as lower levels of proficiency while taking their bottle.

Conclusion

Relationships emerged between higher maternal eating disorder symptoms and feeding regulation with substantial gender differences in these patterns. Additional research clarifying the underlying mechanisms of these associations is warranted and further efforts should be directed towards supporting mothers during the postpartum period.

Development of a postnatal educational program for breastfeeding mothers in community settings: intervention mapping as a useful guide

Inconsistency in how professionals can best support the breastfeeding mother after discharge call on further investigation. The authors describe how intervention mapping was used to develop a postnatal breastfeeding support intervention for mothers in community settings. Breastfeeding cessation most often occurred in the first weeks among mothers with low self-efficacy, low confidence, or limited previous breastfeeding experience. Besides learning effective breastfeeding techniques, mothers needed to learn how to recognize their baby's cues, let the baby regulate meals, gain confidence in producing enough milk, and handle breastfeeding problems. Theory-based methods-such as individualization, skills training with guided practice, reattribution, planning coping responses, and mobilizing social support-were built into a health visitor-delivered program. An 18-hour training course addressed determinants for implementation. Finally, process and effect evaluations were planned. Support of the breastfeeding mother in community settings should address the psychosocial and practical aspects of breastfeeding to prevent premature cessation.

Learning experiences in feeding behaviour during infancy

In early infancy, the method of feeding from either the breast or the bottle results in the establishment of different patterns of meal size across the day. In breast-fed infants the change in size of meals across the 24 hr period is evidence for the acquisition of an anticipatory pattern of intake which is unlikely to occur in bottle-fed infants because of restrictions in the amount of milk offered at each meal. Other measures of behaviour within feeds support the development of a baby-controlled style of feeding in breast-fed infants compared with a mother-controlled feeding style in the bottle-fed infant. Associated with these patterns of intake are variations in the perceived hunger of infants by their mothers, with hunger variation being recognized with greater frequency in females than in males. In older infants the establishment of cultural rules of eating and the use of parental strategies to manipulate eating in children provide further evidence for the importance of learning in the establishment of early feeding behaviour.