Ecological momentary assessment of using food to soothe during infancy in the INSIGHT trial.

Elizabeth L Adams, Michele E Marini, Timothy R Brick, Ian M Paul, Leann L Birch, Jennifer S Savage

Journal: The international journal of behavioral nutrition and physical activity 2020;16(1):79

PMID: 31488156

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Abstract

BACKGROUND

Use of food to soothe infant distress has been linked to greater weight in observational studies. We used ecological momentary assessment to capture detailed patterns of food to soothe and evaluate if a responsive parenting intervention reduced parents' use of food to soothe.

METHODS

Primiparous mother-newborn dyads were randomized to a responsive parenting intervention designed for obesity prevention or a safety control group. Responsive parenting curriculum included guidance on using alternative soothing strategies (e.g., swaddling), rather than feeding, as the first response to infant fussiness. After the initial intervention visit 3 weeks after delivery, mothers (n = 157) were surveyed for two 5-8 day bursts at infant ages 3 and 8 weeks. Surveys were sent via text message every 4 h between 10:00 AM-10:00 PM, with 2 surveys sent at 8:00 AM asking about nighttime hours. Infant fusses and feeds were reported for each 4-h interval. Food to soothe was defined as "Fed First" and "Not Fed First" in response to a fussy event. Use of food to soothe was modeled using random-intercept logistic regression.

RESULTS

The control group had greater odds of having Fed First, compared to the responsive parenting group at ages 3 and 8 weeks (3 weeks: OR = 1.9; 95% CI = 1.4-2.7; p < 0.01; 8 weeks: OR = 1.4; 95% CI = 1.0-2.1; p = 0.053). More responsive parenting mothers reported using a responsive parenting intervention strategy first, before feeding, than controls at ages 3 and 8 weeks (3 weeks: 58.1% vs. 41.9%; 8 weeks: 57.1% vs. 42.9%, respectively; p < 0.01 for both). At both ages combined, fewer fusses from responsive parenting infants were soothed best by feeding compared to controls (49.5% vs. 61.0%, respectively; p < 0.01). For both study groups combined, parents had greater odds of having Fed First during the nighttime compared to the daytime at both ages (3 weeks: OR = 1.6, 95% CI = 1.4-1.8; p < 0.01; 8 weeks: OR = 2.1; 95% CI = 1.7-2.6; p < 0.01).

CONCLUSIONS

INSIGHT's responsive parenting intervention reduced use of food to soothe and increased use of alternative soothing strategies in response to infant fussiness. Education on responsive parenting behaviors around fussing and feeding during early infancy has the potential to improve later self-regulation and weight gain trajectory.

TRIAL REGISTRATION

NCT01167270 . Registered July 21, 2010.

Address: Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.; Department of Nutritional Sciences, Penn State University, University Park, PA, USA.; Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.; Department of Human Development and Family Studies, Penn State University, University Park, PA, USA.; Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.; Department of Foods and Nutrition, University of Georgia, Athens, GA, USA.; Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA. [email protected].; Department of Nutritional Sciences, Penn State University, University Park, PA, USA. [email protected].

DOI: 10.1186/s12966-019-0837-y

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MeSH Terms: Ecological Momentary Assessment, Female, Food, Food Fussiness, Humans, Infant, Infant, Newborn, Mothers, Parenting, Surveys and Questionnaires