Article summary with Development of the responsiveness to child feeding cues scale by Hodges a.o. - 2013

What is this article about?   

Obesity is common in US children and adults, also in children between age of 0-2 years. People who are obese during their childhood experience difficulties to reduce their weight during adolescents and adulthood.

The first years of a child's life are crucial for developing a healthy eating behavior. However, during those years, infants and their eating behavior depends on their caregiver. If the children’s signals are not interpreted correctly eating in absence of hunger can occur, resulting in over-nutrition. If children are fed according to their signals, development of appetite control can be supported. The definition of parental responsiveness to child feeding is build on the broader definition of parental responsiveness. The definition entails three components: (1) perception of the child’s cue, (2) accurate interpretation of the cue and (3) appropriate response to the cue. Previous research about responsive feeding has been conducted with preschool aged children and data collection of parents’ self-report.

This article aims to report the development and psychometric evaluation of observational measures of caregiver responsiveness to feeding cues of their children until the age of two years.

How was this study conducted?

Via convenience sampling recruited participants for this study were mothers and their children between the age of 7-24 months who already took part in a larger study regarding dietary assessment methods. The mothers taking part in this study were from diverse ethnicities. Aiming to reduce social desirability, participants with a degree in nutrition and/ or psychology were not allowed to take part in this study.

To collect data, feeding sessions were recorded. The mothers were asked not to feed their children before the feeding sessions. During the observations, the mothers were asked to feed their child the same way and as often as they would usually. One of the used instruments was the Responsiveness to Child Feeding Cues Scale (RCFCS), a coding scheme to assess child’s feeding cues. The development and use of this coding scheme was part of the current study.

What were the results of this study and how can they be interpreted?

The observations showed that mothers who are overall responsive to their child’s cues are also responsive to the child’s feeding cues, and in turn, the children of responsive mothers showed a high responsiveness to their mother. Mothers reporting higher education, higher income and less children at home were shown to be relatively more responsive towards their children.

Previous recommendations and efforts to develop a healthy feeding relationship was largely based on experts, rather than on science. However, the RCFCS coding scheme shows promising results in being an useful assessment tool. This coding scheme showed to have a high inter-rater reliability for most items, besides the physical disposition of children and mothers during feeding.

After analyzing the results, mothers showed a higher responsiveness to hunger cues than to fullness cues, which can reflect humans’ universal needs and parental goal to ensure their children’s survival. Mothers who breastfed their children longer, showed a higher responsiveness to fullness cues.