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Development, Feeding Skills and Relationships. What factors influence food choices, eating behaviors, and acceptance?. Sociology of Food. Hunger Social Status Social Norms Religion/Tradition Nutrition/Health. Sociology of Food. Food Choices Availability Cost Taste Value

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Development, Feeding Skills and Relationships

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Development, Feeding Skills and Relationships

  • What factors influence food choices, eating behaviors, and acceptance?

Sociology of Food

  • Hunger

  • Social Status

  • Social Norms

  • Religion/Tradition

  • Nutrition/Health

Sociology of Food

  • Food Choices

    • Availability

    • Cost

    • Taste

    • Value

    • Marketing Forces

    • Health

    • Significance

Feeding Practices and Transitions





Public Health

Foods for infants and young children

  • Nurturing

  • Nourishing

  • Learning

    • Relationship

    • Development

    • Emotion and temperament

The feeding relationship in infancy

  • Nourishing and nurturing

  • Supports developemental tasks


  • Feeding is a reciprocal process that depends on the abilities and characteristics of both caregiver and infant/child


  • The feeding relationship is both dependent on and supportive of infants development and temperament.


  • Children do best with feeding when they have both control and support

Maternal-Infant Feeding dyad

  • Indicates hunger (I)

  • Presents milk (M)

  • Consumes milk by suckling (I)

  • Indicates satiety, stops suckling (I)

  • Ends feeding (M)



how much




food choices



structure and limits




  • Neurophysiologic

    • Homeostasis

    • Attachment

    • Separation and individuation

  • Oral Motor

Stages of Development

  • Homeostasis

  • Attachment

  • Separation and individuation



  • Supportive and responsive

    • Homeostasis

    • Attachment

    • Separation and individuation

    • Security

    • Well-being

    • Temperament

    • Needs

    • other

Infant and Caregiver Interaction

  • Readability

  • Predictability

  • Responsiveness

Feeding Problems

  • Homeostasis

    • Colic, poor growth, stressful unsatisfactory feedings

  • Attachment

    • Vomiting, diarrhea, poor growth, disengaged or intensely conflicted feeding interactions

  • Individuation

    • Food refusal

  • Problems established early in feeding persist into later life and generalize into other areas

  • Ainsworth and Bell

    • feeding interactions in early months were replicated in play interactions after 1st year



  • Temperament theory categorizes enduring personality styles based on activity, adaptability, intensity, mood, persistence, distractibility, regularity, responsivity, approach/withdraw from novelty

    Chess and Thomas 1970


  • Easy: approaches novelty, positive mood, adaptable, regular, active, low intensity

  • Slow to warm: withdraws from novelty, low mood, low activity, moderate to low intensity, cautious

  • Difficult: withdrawing, low adaptability, high intensity, low regularity, negative mood

Play, Learning, Exploration

Feeding behavior of infants Gessell A, Ilg FL

Developmental Changes

  • Oral cavity enlarges and tongue fills up less

  • Tongue grows differentially at the tip and attains motility in the larger oral cavity.

  • Elongated tongue can be protruded to receive and pass solids between the gum pads and erupting teeth for mastication.

  • Mature feeding is characterized by separate movements of the lip, tongue, and gum pads or teeth

Development of Infant Feeding Skills

  • Birth

    • tongue is disproportionately large in comparison with the lower jaw: fills the oral cavity

    • lower jaw is moved back relative to the upper jaw, which protrudes over the lower by approximately 2 mm.

    • tongue tip lies between the upper and lower jaws.

    • "fat pad" in each of the cheeks: serves as prop for the muscles in the cheek, maintaining rigidity of the cheeks during suckling.

    • feeding pattern described as “suckling”

Analytical framework for the Start Healthy Guidelines for Complementary foods (JADA, 2004)


  • Establish healthy feeding relationship

    • Recognize child’s developmental abilities

    • Balance child’s need for assistance with encouragement of self feeding

    • Allow the child to initiate and guide feeding interactions

    • Respond early and appropriately to hunger and satiety cues

Analytical framework for the Start Healthy Guidelines for Complementary foods (JADA, 2004)

  • Provide guidance consistent with family/child’s

    • Development

    • Temperament

    • Preferences

    • Culture

    • Nutritional needs

The End

Case: Quinn

  • 6 weeks old

  • Breastfed from birth

  • Readmitted at two days for dehydration

    • formula supplementation, lactation consult

    • Breastfeeding successfully established

  • “fussy, irritable, ? Colic”


  • Family constellation:

    • Mother (33 yrs): works as an architect for large firm. On 3 month family leave

    • Father (35 yrs): Psychologist

    • Quinn is first child (IVF)


  • Mother is concerned about Quinn’s “fussy, colicky” behavior, development, and sleep

    • ? Allergy, not enough milk, should she avoid certain foods. Has asked her pediatrician several times if there is a medical problem.

    • ? Foods she can eat to help Quinn’s IQ and development, did early formula “hurt” Quinn

    • Would like Quinn to develop good sleep habits and has read conflicting information on whether Quinn should sleep in same bed, same room, or away from parents.


  • Quinn is fed on demand, at least 12 times a day. Seems to feed best in the evening between 7PM and 5AM (3-4 times)

  • Indicates hunger clearly, but can “escalate and be hard to settle down”

  • During day, demands frequently, nurses one side, 3-5 minutes, then refuses other side, although may not appear “comforted”

Case: Sam

10 months old male. 2 older siblings (4 yrs and 2 yrs). Mother works as a cashier at a grocery store. Father is in the navy, and is often away from home.

Sam and his siblings are cared for by maternal grandmother during the day


  • Feeding history:

    • Formula fed from birth. As a newborn, was demand fed but by six weeks was schedule fed (q4 hours)

    • Given first solids at 2 months (rice cereal) “to sleep through the night”

    • By 6 months offered 3 meals/day (cereal, fruit/vegetables, meat) (stage 1 foods)


  • Healthy

  • Wt 75th %ile, Length 90th %ile, OFC 75-90th %ile

  • 24 oz formula (“2 bottles during day, one at naptime, and one at bedtime”

  • Table foods with siblings:

    • Breakfast: eggs, cereal, or pancakes, juice

    • Lunch: hot dogs or macaroni and cheese or sandwich, fruit, cup of milk

    • Dinner: family dinner: meat or casserole, vegetable, and “a starch”, cup of milk

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