INSIGHT 响应式育儿干预和婴儿喂养方式：随机临床试验。
INSIGHT responsive parenting intervention and infant feeding practices: randomized clinical trial.
机构信息
Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
出版信息
Int J Behav Nutr Phys Act. 2018 Jul 9;15(1):64. doi: 10.1186/s12966-018-0700-6.
BACKGROUND
What, when, how, how much, and how often infants are fed have been associated with childhood obesity risk. The objective of this secondary analysis was to examine the effect of a responsive parenting (RP) intervention designed for obesity prevention on parents' infant feeding practices in the first year after birth.
METHODS
Primiparous mother-newborn dyads were randomized to the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study RP intervention or child safety control. Research nurses delivered intervention content at home at infant age 3-4, 16, 28, and 40 weeks, and at a research center at 1 year. RP feeding guidance advised feeding that was contingent (i.e., feed in response to hunger and satiety signs, alternatives to using food to soothe), and developmentally appropriate (i.e., delaying introduction of solids, age-appropriate portion sizes). Infant feeding practices (i.e., bottle use, introduction of solids, food to soothe) were assessed by phone interviews and online surveys and dietary intake was assessed using a food frequency questionnaire.
RESULTS
RP mothers were more likely to use of structure-based feeding practices including limit-setting (p < 0.05) and consistent feeding routines (p < 0.01) at age 1 year. RP group mothers were less likely to use non-responsive feeding practices such as pressuring their infant to finish the bottle/food (p < 0.001), and using food to soothe (p < 0.01), propping the bottle (p < 0.05) assessed between 4 and 8 months, and putting baby to bed with a bottle at age 1 year (p < 0.05). Few differences were seen between groups in what specific foods or food groups infants were fed.
CONCLUSIONS
Anticipatory guidance on RP in feeding can prevent the use of food to soothe and promote use of more sensitive, structure-based feeding which could reduce obesity risk by affecting how and when infants are fed during the first year.
TRIAL REGISTRATION
The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Study. www.clinicaltrials.gov . NCT01167270. Registered 21 July 2010.
背景
婴儿的喂养内容（什么、何时、如何、多少量以及多频繁）与儿童肥胖风险有关。本二次分析的目的是检验一种旨在预防肥胖的促进亲职行为（responsive parenting，RP）干预对婴儿出生后第一年父母喂养方式的影响。
方法
初产妇-新生儿对被随机分配至干预护士启动婴儿健康成长轨迹（Intervention Nurses Start Infants Growing on Healthy Trajectories，INSIGHT）研究的 RP 干预组或儿童安全对照组。研究护士在婴儿 3-4、16、28 和 40 周龄时在家中提供干预内容，并在 1 岁时在研究中心提供。RP 喂养指导建议根据饥饿和饱腹感信号进行喂养（即按需喂养，用食物安抚除外），并建议采用与发育阶段相适应的喂养方法（即延迟固体食物引入，采用适合年龄的食物份量）。通过电话访谈和在线调查评估婴儿喂养方式（即使用奶瓶、引入固体食物、用食物安抚），通过食物频率问卷评估饮食摄入量。
结果
在 1 岁时，RP 母亲更倾向于采用基于结构的喂养方式，包括设定限制（p<0.05）和保持一致的喂养常规（p<0.01）。与对照组相比，RP 组母亲较少采用非响应性喂养方式，例如强迫婴儿喝完奶瓶/食物（p<0.001）、用食物安抚（p<0.01）、用物体支撑奶瓶（p<0.05），这些行为发生在 4-8 月龄；1 岁时，将婴儿含着奶瓶入睡的行为（p<0.05）也较少。两组之间在婴儿喂养的具体食物或食物组方面差异不大。
结论
喂养方面的前瞻性亲职行为指导可以防止使用食物安抚，并促进采用更敏感、基于结构的喂养方式，这可能通过影响婴儿在第一年的喂养方式和时间来降低肥胖风险。
试验注册
干预护士启动婴儿健康成长轨迹（INSIGHT）研究。www.clinicaltrials.gov 。NCT01167270。2010 年 7 月 21 日注册。
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