Project Category: Leveraging Technology for New Insights
Alison K. Ventura, PhD, CLEC
Department of Kinesiology
California Polytechnic State University, San Luis Obispo
Introduction: Caregiver responsiveness promotes infants’ development of effective emotional, cognitive, and behavioral self-regulatory abilities (Leerkes & Wong, 2012), which is predictive of better stress reactivity (Bernard & Dozier, 2010), and lower risk for internalizing and externalizing problems (Lyons-Ruth & Jacobvitz, 1999), and obesity (Power et al., 2016) during later life. Thus, an important foundation for promoting healthy early childhood development is promotion of caregiver responsiveness during caregiver-infant interactions. However, the Institute of Medicine (2011) and others (Lumeng, Taveras, Birch, & Yanovski, 2015) have highlighted the paucity of research aimed at understanding how to promote responsiveness within feeding contexts.
Although there are many reasons why caregivers exhibit low responsiveness during feeding interactions, few studies have examined how maternal distraction (e.g., watching TV, using a mobile device) may impact feeding interactions and outcomes. Given the ever-increasing accessibility of handheld technologies (Pew Research Center, 2014), combined with the large number of daily feedings required by young infants (Fomon, 1993), it is possible that many caregivers regularly attend to distractors as a means to cope with the large volume of time they must dedicate to feeding. Objectives of the present research were to describe the prevalence of maternal distraction during feeding (Study 1) and experimentally test the impact of maternal distraction on feeding interactions (Study 2).
A convenience sample of mothers with 0-6-month-old infants were recruited through community advertisements. Study 1 included 75 dyads and Study 2 included 17 dyads (data collection is ongoing).
Study 1: Mothers kept a diary of their infants’ feeding patterns for 1-6 days. For each recorded feeding, mothers also described what else, if anything, they were doing during the feeding.
Study 2: For this within-subject, experimental study, mother-infant dyads visited our laboratory two times for feeding observations. Mothers were video-recorded while feeding their infants under two conditions, presented in counterbalanced order. During the no distraction condition, mothers fed their infants while listening to classical music played at ambient levels. During the TV distraction condition, mothers fed their infants while watching a TV show. Infant intake was assessed by weighing the baby (breast-feeding dyads) or bottle (bottle-feeding dyads) before and after the feeding. Videos were coded by two coders trained in the Nursing Child Assessment Feeding Scale [NCAFS; (Sumner & Spitz, 1994)].
Results: Study 1: Of the 2982 reported feedings, distractions were reported during 47% of feedings, with 26% of feedings involving a technological distractor. On an individual-level, mothers’ reports of any distraction ranged from 0-100% of feedings (M=47.4±30.2%) and reports of technological distractions ranged from 0-97% of feedings (M=27.9±24.0%).
Study 2: When mothers’ typical level of technological distraction was tested as a moderator of effects of condition, a significant interaction was seen for infants’ clarity of cues (P=0.01) and responsiveness to the mother (P=0.05). Infants of mothers with high typical levels of technological distraction significantly increased in their clarity of cues (P<0.001) and responsiveness to the mother (P=0.04) during the TV distraction compared to the no distraction condition. Similar increases in these outcomes were not seen for infants of mothers with low typical levels of distraction. No effect of condition or interaction between condition and typical level of distraction was seen for infants’ intake or mothers’ sensitivity to infant cues, response to infant distress, socioemotional growth fostering, or cognitive growth fostering.
Discussion: These studies are among the first to explore the prevalence and impact of maternal distraction during feeding. Descriptive findings from Study 1 illustrated mothers attend to environmental stimuli during almost half of reported feedings, and, for over a quarter of reported feedings, these stimuli consist of technological distractions. Preliminary analyses from Study 2 illustrated infants respond to technological distractions by increasing the clarity of their cues and responsiveness to their mothers, but this may be a learned response that depends on the dyad’s history of distracted feeding. Limitations of these findings include their reliance on self-reported data (Study 1), and small and homogeneous sample (Study 2).
Future research should include larger and more diverse samples to improve the generalizability of findings. Inclusion of additional objective measures of infant and maternal physiological and behavioral responses to distractions will also provide novel data on mechanisms underlying impacts of distracted feeding on feeding outcomes. The potential impact of maternal distraction on both short-term and long-term feeding and developmental outcomes is an important question for future inquiry and may lead to novel education efforts to improve maternal responsiveness, as well as the quality of maternal-infant interactions, during early feeding.
Alison K. Ventura, PhD, CLEC
Department of Kinesiology
California Polytechnic State University, San Luis Obispo
One Grand Ave, 43A-371
San Luis Obispo, CA 93407
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