Author: Kathryn Webb, Accredited Practising Dietitian, Paediatric Dietitian
Introduction
The first 1000 days is the period of development from conception to 2 years of age. It is well known in the research world that this period of time is crucial in establishing lifelong healthy eating habits and reducing the risk of chronic diseases later in life (Schwarzenberg et al, 2018). We also know that food preferences that begin early in life can stay with your child until adulthood (Schwartz et al, 2011). Unfortunately, stressful feeding experiences during this time have the potential to interfere with the development of healthy eating habits and can impact feeding through infancy, into childhood and beyond (Maniam and Morris, 2012),
Early life feeding stress – causes and consequences.
There are many factors that might play a part in early life feeding stress and the implications can be long lasting. Maternal factors that may contribute to feeding stress include concerns about breast milk supply, mum’s receiving conflicting or contradictory advice, stressful or traumatic birth experiences and maternal sense of empowerment. Infant factors that may contribute to feeding stress include prematurity, tube feeding, any adverse reactions to foods such as allergies and intolerances, growth faltering and other medical conditions that may affect feeding. There are also a range of other socioeconomic, cultural, and religious factors that may contribute to early life feeding stress.
As a consequence of feeding stress, caregivers may naturally resort to food parenting practices that might be counterproductive in supporting a healthy relationship with food. There is growing evidence that feeding with distractions, offering drinks instead of foods, force feeding, and coercion do not support a healthy relationship with food.
What are ‘Food Parenting Practices’?
Food parenting practices include strategies used to guide ‘what,’ ‘when’ and ‘how’ children eat. The research talks about a variety of food parenting practices that can impact our little one’s relationship with food. These are outlined below:
Coercive control feeding practices include pressure to eat, use of threats and bribes, restriction, use of food to control negative emotions. These practices may negatively impact children’s feeding behaviours (Vaughn et al, 2016) but may come naturally to parents who experienced this approach as children themselves.
Structure encompasses rules and limits, guided choices, monitoring, routines, atmosphere, distractions, modeling, food availability, food accessibility, food preparation (Vaughn et al, 2016).
Autonomy support or promotion may include nutrition education, child involvement, encouragement, praise, reasoning, and negotiation (Vaughn et al, 2016).
Our favourite = Responsive Feeding and the Division of Responsibility
Responsive feeding is especially important for infants and toddlers during the transition to solids that occurs between 6 and 24 months of age. Responsive feeding practices can impact a child’s weight status and lay the foundation for the development of healthy eating behaviours. ‘Responsive feeding’ is about timely and developmentally appropriate responses to children’s hunger and satiety cues, providing clear mealtime structure and setting a warm emotional tone to the feeding environment (Barrett et al, 2023). This is where the concept of the division of responsibility comes in. The division of responsibility outlines that it is the parents’ responsibility to decide what, when and where to feed their infant, and the infant decides how much he/she wants to eat (Satter, 2023). You can read more about it here: division of responsibility.
Kathryn’s PhD project is about empowering parents and caregivers and giving them the skills to sensitively and respectively observe and respond to their child’s feeding cues.:
The overarching goal of the project is to improve infant nutrition and reduce mealtime stress. The ‘Happy Parenting Project’ is investigating whether different styles of parenting classes improve various outcomes for parents, including stress and sense of competence. Parents and their babies are randomly assigned to either online, indoor, or outdoor classes which are run once a week for 8 weeks. The project is now recruiting infants around 3-6 months of age for classes starting in Term 1, 2024. Please e-mail parenting@ecu.edu.au to register your interest.
The role of a Paediatric Dietitian in feeding
A Paediatric Dietitian can help with nutritional rehabilitation following a period of stressful feeding and help with unpacking early life stressful feeding experiences and provide strategies to move forward from these experiences. Our team at Advanced Dietitians Group are experienced paediatric dietitians with expertise in feeding difficulties. We have been trained in the Ellen Satter’s Division of Responsibility approach to feeding and in the Sequential Oral Sensory (SOS) approach to feeding. If you are seeking extra support for your child, click here to read more about our team or here to book an appointment.
About the Author
Kathryn Webb is a Perth Dietitian specialising in paediatric nutrition, infant and toddler nutrition, allergies, and pregnancy nutrition. She has been a dietitian for 20 years. She has worked as a Senior Dietitian and Paediatric Dietitian in various teaching hospitals in Australia and the United Kingdom. She is a mum of three young children and knows firsthand how challenging feeding children can be.
References:
- Camille Schwartz, Petra A.M.J. Scholtens, Amandine Lalanne, Hugo Weenen, Sophie Nicklaus, Development of healthy eating habits early in life. Review of recent evidence and selected guidelines, Appetite, Volume 57, Issue 3, 2011, Pages 796-807, ISSN 0195-6663, https://doi.org/10.1016/j.appet.2011.05.316.
- Maniam J, Morris MJ. The link between stress and feeding behaviour. Neuropharmacology. 2012 Jul;63(1):97-110. doi: 10.1016/j.neuropharm.2012.04.017. Epub 2012 Apr 24. PMID: 22710442.
- Schwarzenberg SJ, Georgieff MK, AAP COMMITTEE ON NUTRITION. Advocacy for Improving Nutrition in the First 1000 Days To Support Childhood Development and Adult Health. Pediatrics. 2018;141(2):e20173716
- Vaughn AE, Ward DS, Fisher JO, Faith MS, Hughes SO, Kremers SPJ, Musher-Eizenman DR, O’Connor TM, Patrick H and Power TG. Fundamental constructs in food parenting practices: a content map to guide future research. Nutrition Reviews 74(2): 98-117. Available: doi: 10.1093/nutrit/nuv061
- Satter, E. Satter Division of Responsibility in Feeding. 2023. Available: sDOR-in-feedng.pdf (ellynsatterinstitute.org)
