RTI International, Research Triangle Park, NC 27709, USA.
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Nutrients. 2022 Jul 30;14(15):3156. doi: 10.3390/nu14153156.
Young children's growth is influenced by food and feeding behavior. Responsive feeding has been shown to promote healthy growth and development, to prevent under- and overfeeding, and to encourage children's self-regulation. However, most measures of responsive feeding do not incorporate bidirectional mother-infant responsivity or early learning principles and have not been validated against observations. To overcome these gaps, we laid the groundwork for a responsive feeding measure based on a community sample of 67 mothers and their 6-18-month-old children in Bangladesh. Children were weighed and measured. Mothers reported on their child's dietary intake and responded to a 38-item responsive feeding questionnaire developed through a 2-phase Delphi procedure. Based on a video-recorded feeding observation, mother-child dyads were categorized into proximal (43%) and distal (57%) responsivity groups. Using stepwise logistic regression, a 9-item model from the responsive feeding questionnaire had excellent fit (AUC = 0.93), sensitivity (90%), specificity (89%), positive predictive value (87%), and negative predictive value (93%). Proximal responsivity was characterized by maternal concerns about children's dietary intake. Distal responsivity was characterized by maternal perception of children's happy mood during feeding. Findings support responsive feeding as modulating between proximal and distal responsivity, promoting autonomy, self-regulation, and enabling children to acquire and practice healthy eating behaviors.
儿童的生长发育受到食物和喂养行为的影响。有研究表明，响应式喂养可以促进健康的生长和发育，防止喂养不足或过度，并鼓励儿童自我调节。然而，大多数响应式喂养的衡量标准都没有纳入母婴双向反应性或早期学习原则，也没有通过观察得到验证。为了克服这些差距，我们在孟加拉国的一个社区样本中为一项基于响应式喂养的措施奠定了基础，该样本包括 67 名母亲及其 6-18 个月大的孩子。对孩子进行称重和测量。母亲报告了孩子的饮食摄入量，并对通过两阶段德尔菲程序开发的 38 项响应式喂养问卷做出了回应。根据一段视频记录的喂养观察，将母婴对子分为近端（43%）和远端（57%）反应性组。使用逐步逻辑回归，来自响应式喂养问卷的 9 项模型具有出色的拟合度（AUC=0.93）、敏感性（90%）、特异性（89%）、阳性预测值（87%）和阴性预测值（93%）。近端反应性的特点是母亲对孩子的饮食摄入表示关注。远端反应性的特点是母亲在喂养过程中感知到孩子的愉快情绪。研究结果支持响应式喂养在近端和远端反应性之间进行调节，促进自主性、自我调节，并使儿童能够获得和实践健康的饮食习惯。
