University of Colorado Anschutz Medical Campus, Department of Pediatrics, Section of Nutrition, Aurora, CO, United States.
Purdue University, Department of Human Development and Family Studies, West Lafayette, IN, United States.
J Nutr. 2023 Apr;153(4):1297-1304. doi: 10.1016/j.tjnut.2023.01.034. Epub 2023 Feb 2.
Responsive feeding is important for helping children to develop healthy eating behaviors. Verbal feeding interactions between caregivers and children may reflect caregiver's responsiveness and contribute to children's developing lexical networks related to food and eating.
This project aimed to: 1) characterize what caregivers say to infants and toddlers during a single feeding session and 2) test the associations between caregiver's verbal prompts and food acceptance by children.
Filmed interactions of caregivers and their infants (N = 46 infants aged 6-11 mo) and toddlers (N = 60 toddlers aged 12-24 mo) were coded and analyzed to explore the following: 1) what caregivers said during a single feeding session and 2) whether caregiver's verbalizations were associated with child food acceptance. Caregiver verbal prompts were coded during each food offer and summed across the feeding session; prompts were categorized as supportive, engaging, and unsupportive. Outcomes included accepted tastes, rejected tastes, and rate of acceptance. Mann-Whitney's U tests and Spearman's correlations tested bivariate associations. Multilevel ordered logistic regression tested associations between verbal prompt categories and the rate of acceptance across offers.
Verbal prompts were largely supportive (41%) and engaging (46%), and caregivers of toddlers used significantly more verbal prompts than caregivers of infants (mean ± SD: 34.5 ± 16.9 compared with 25.2 ± 11.6; P = 0.006). Among toddlers, more engaging and unsupportive prompts were associated with a lower rate of acceptance (ρ = -0.30, P = 0.02; ρ = -0.37, P = 0.004). For all children, multilevel analyses revealed that more unsupportive verbal prompts were associated with a lower rate of acceptance (b = -1.52; SE = 0.62; P = 0.01) and individual caregiver use of more engaging and unsupportive prompts than usual was associated with a lower rate of acceptance (b = -0.33; SE = 0.08; P < 0.001: b = -0.58; SE = 0.11; P < 0.001).
These findings suggest that caregivers may strive for a supportive and engaging emotional setting during feeding, although verbalization category may change as children exhibit more rejection. Furthermore, what caregivers say may change as children develop more advanced language capabilities.
响应式喂养对于帮助儿童养成健康的饮食习惯很重要。照顾者与儿童之间的口头喂养互动可以反映照顾者的响应能力，并有助于儿童发展与食物和进食相关的词汇网络。
本项目旨在：1）描述照顾者在单次喂养过程中对婴儿和幼儿说的话；2）测试照顾者的口头提示与儿童食物接受度之间的关联。
对照顾者及其婴儿（6-11 个月大的婴儿，N=46）和幼儿（12-24 个月大的幼儿，N=60）的互动进行了录像，并进行了编码和分析，以探讨以下问题：1）照顾者在单次喂养过程中说了什么；2）照顾者的言语是否与儿童的食物接受度有关。在每次提供食物时对照顾者的提示进行编码，并在喂养过程中进行汇总；提示分为支持性、参与性和非支持性。结果包括接受的口味、拒绝的口味和接受率。曼-惠特尼 U 检验和斯皮尔曼相关检验用于检验双变量关联。多级有序逻辑回归检验了口头提示类别与各个提供之间接受率的关联。
口头提示主要是支持性（41%）和参与性（46%），幼儿的照顾者比婴儿的照顾者使用的口头提示明显更多（均值±标准差：34.5±16.9 与 25.2±11.6；P=0.006）。在幼儿中，更多的参与性和非支持性提示与较低的接受率相关（ρ=-0.30，P=0.02；ρ=-0.37，P=0.004）。对于所有儿童，多层次分析显示，更多的非支持性口头提示与较低的接受率相关（b=-1.52；SE=0.62；P=0.01），并且个别照顾者比平时更多地使用参与性和非支持性提示与较低的接受率相关（b=-0.33；SE=0.08；P<0.001：b=-0.58；SE=0.11；P<0.001）。
这些发现表明，照顾者在喂养过程中可能会努力营造一种支持性和参与性的情感环境，尽管随着儿童表现出更多的拒绝，言语类别可能会发生变化。此外，随着儿童语言能力的发展，照顾者的说话方式也可能会发生变化。
