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Maternal Perceptions of Infant Hunger, Satiety, and Pressuring Feeding Styles in an Urban Latina WIC Population

  • Rachel S. Gross
    Correspondence
    Address correspondence to Rachel S. Gross, MD, MS, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, 3444 Kossuth Avenue, Bronx, New York 10467-2490.
    Affiliations
    Department of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Gross); General Pediatrics (Dr Fierman and Dr Messito) and Developmental-Behavioral Pediatrics (Dr Mendelsohn), New York University School of Medicine, New York, NY; and Research and Evaluation Unit, Public Health Solutions, New York, NY (Drs Chiasson, Rosenberg, and Ms Scheinmann)
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  • Arthur H. Fierman
    Affiliations
    Department of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Gross); General Pediatrics (Dr Fierman and Dr Messito) and Developmental-Behavioral Pediatrics (Dr Mendelsohn), New York University School of Medicine, New York, NY; and Research and Evaluation Unit, Public Health Solutions, New York, NY (Drs Chiasson, Rosenberg, and Ms Scheinmann)
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  • Alan L. Mendelsohn
    Affiliations
    Department of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Gross); General Pediatrics (Dr Fierman and Dr Messito) and Developmental-Behavioral Pediatrics (Dr Mendelsohn), New York University School of Medicine, New York, NY; and Research and Evaluation Unit, Public Health Solutions, New York, NY (Drs Chiasson, Rosenberg, and Ms Scheinmann)
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  • Mary Ann Chiasson
    Affiliations
    Department of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Gross); General Pediatrics (Dr Fierman and Dr Messito) and Developmental-Behavioral Pediatrics (Dr Mendelsohn), New York University School of Medicine, New York, NY; and Research and Evaluation Unit, Public Health Solutions, New York, NY (Drs Chiasson, Rosenberg, and Ms Scheinmann)
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  • Terry J. Rosenberg
    Affiliations
    Department of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Gross); General Pediatrics (Dr Fierman and Dr Messito) and Developmental-Behavioral Pediatrics (Dr Mendelsohn), New York University School of Medicine, New York, NY; and Research and Evaluation Unit, Public Health Solutions, New York, NY (Drs Chiasson, Rosenberg, and Ms Scheinmann)
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  • Roberta Scheinmann
    Affiliations
    Department of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Gross); General Pediatrics (Dr Fierman and Dr Messito) and Developmental-Behavioral Pediatrics (Dr Mendelsohn), New York University School of Medicine, New York, NY; and Research and Evaluation Unit, Public Health Solutions, New York, NY (Drs Chiasson, Rosenberg, and Ms Scheinmann)
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  • Mary Jo Messito
    Affiliations
    Department of General Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY (Dr Gross); General Pediatrics (Dr Fierman and Dr Messito) and Developmental-Behavioral Pediatrics (Dr Mendelsohn), New York University School of Medicine, New York, NY; and Research and Evaluation Unit, Public Health Solutions, New York, NY (Drs Chiasson, Rosenberg, and Ms Scheinmann)
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Published:December 11, 2009DOI:https://doi.org/10.1016/j.acap.2009.08.001

      Objective

      Controlling feeding styles in which parents regulate feeding without responding to child cues have been associated with poor self-regulation of feeding and increased weight, but have not been well studied in infancy. We sought to assess maternal perception of infant feeding cues and pressuring feeding styles in an urban Latina Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) population.

      Methods

      Secondary analysis of a larger study of Latina mothers participating in New York City WIC programs. We examined maternal perception of infant feeding cues and pressuring feeding style. Using logistic regression, we assessed: 1) characteristics associated with perceptions of cues and pressuring to feed, including sociodemographics, breastfeeding, and maternal body mass index; and 2) whether perceptions of cues were associated with pressuring feeding style.

      Results

      We surveyed 368 mothers (84% response rate). Most mothers perceived that babies sense their own satiety. However, 72% believed that infant crying must indicate hunger. Fifty-three percent believed that mothers should always make babies finish the bottle (“pressure to feed”). Pressuring feeding style was associated with foreign maternal country of birth (adjusted odds ratio [AOR] 3.05; 95% confidence interval [CI], 1.66–5.60) and less than a high school education (AOR 1.81; 95% CI, 1.12–2.91). Two perceptions of feeding cues were related to pressuring feeding style: belief that infant crying must indicate hunger (AOR 2.59; 95% CI, 1.52–4.42) and infant hand sucking implies hunger (AOR 1.83; 95% CI, 1.10–3.03).

      Conclusions

      Maternal characteristics influence perception of infant hunger and satiety. Interpretation of feeding cues is associated with pressuring feeding style. Improving responsiveness to infant cues should be a component of early childhood obesity prevention.

      Key Words

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