Amanda L. Thompson

Development and validation of the Infant Feeding Style Questionnaire

This study describes and validates the Infant Feeding Style Questionnaire (IFSQ), a self-report instrument designed to measure feeding beliefs and behaviors among mothers of infants and young children. Categorical confirmatory factor analysis was used to estimate latent factors for five feeding styles, laissez-faire, restrictive, pressuring, responsive and indulgent, and to validate that items hypothesized a priori as measures of each style yielded well-fitting models. Models were tested and iteratively modified to determine the best fitting model for each of 13 feeding style sub-constructs, using a sample of 154 low-income African-American mothers of infants aged 3-20 months in North Carolina. With minor changes, models were confirmed in an independent sample of 150 African-American first-time mothers, yielding a final instrument with 39 questions on maternal beliefs, 24 questions on behaviors and an additional 20 behavioral items pertaining to solid feeding for infants over 6 months of age. Internal reliability measures for the sub-constructs ranged from 0.75 to 0.95. Several sub-constructs, responsive to satiety cues, pressuring with cereal, indulgent pampering and indulgent soothing, were inversely related to infant weight-for-length z-score, providing initial support for the validity of this instrument for assessing maternal feeding beliefs and behaviors that may influence infant weight outcomes.

Infants Perceived as “Fussy” Are More Likely to Receive Complementary Foods Before 4 Months

OBJECTIVE: Our purpose was to assess early infant-feeding patterns in a cohort of low-income black mothers and to examine associations between maternal perception of infant temperament and complementary feeding (CF) before 4 months. METHODS: We used cross-sectional data from the 3-month visit (n = 217) of the Infant Care, Feeding and Risk of Obesity Study to assess relationships between early feeding of solids or juice and 6 dimensions of perceived infant temperament. Descriptive statistics were used to assess infant-feeding patterns, and logistic regression models were fit for each diet-temperament relationship found significant in the bivariate analyses. RESULTS: Seventy-seven percent of the infants were fed solid foods at 3 months, 25% were fed juice, and 6% were exclusively breastfed. In multivariable analyses, 2 dimensions of perceived infant temperament were associated with early feeding of solid foods (distress-to-limitations odds ratio [OR]: 1.97 [95% confidence interval (CI): 1.12–3.44]; activity-level OR: 1.75 [95% CI: 1.07–2.85]), whereas 1 dimension, low-intensity pleasure, was associated with early feeding of juice (OR: 0.51 [95% CI: 0.34–0.78]). Maternal characteristics significantly associated with early CF included breastfeeding, obesity, and depressive symptoms. CONCLUSIONS: Low-income black mothers may represent a priority population for interventions aimed at improving adherence to optimal infant feeding recommendations. That maternal perceptions of several domains of perceived infant temperament are related to early CF suggests that this is an important factor to include in future observational research and in the design of interventions.

Developmental origins of obesity: Early feeding environments, infant growth, and the intestinal microbiome

Pediatric overweight and obesity are growing problems worldwide, with increasing prevalence among even infants and young children. The refractory nature of early overweight necessitates identifying the factors contributing to early excess weight gain for successful intervention. Early feeding practices may be particularly important in shaping long‐term vulnerability to obesity. How and what infants are fed can influence weight gain, adiposity, and energy metabolism during infancy and across the life course through a number of interacting physiological and behavioral pathways. This article argues that these biological mechanisms interact with the social and behavioral context of infant feeding to create differential vulnerability to later obesity.

Milk- and solid-feeding practices and daycare attendance are associated with differences in bacterial diversity, predominant communities, and metabolic and immune function of the infant gut microbiome

The development of the infant intestinal microbiome in response to dietary and other exposures may shape long-term metabolic and immune function. We examined differences in the community structure and function of the intestinal microbiome between four feeding groups, exclusively breastfed infants before introduction of solid foods (EBF), non-exclusively breastfed infants before introduction of solid foods (non-EBF), EBF infants after introduction of solid foods (EBF+S), and non-EBF infants after introduction of solid foods (non-EBF+S), and tested whether out-of-home daycare attendance was associated with differences in relative abundance of gut bacteria. Bacterial 16S rRNA amplicon sequencing was performed on 49 stool samples collected longitudinally from a cohort of 9 infants (5 male, 4 female). PICRUSt metabolic inference analysis was used to identify metabolic impacts of feeding practices on the infant gut microbiome. Sequencing data identified significant differences across groups defined by feeding and daycare attendance. Non-EBF and daycare-attending infants had higher diversity and species richness than EBF and non-daycare attending infants. The gut microbiome of EBF infants showed increased proportions of Bifidobacterium and lower abundance of Bacteroidetes and Clostridiales than non-EBF infants. PICRUSt analysis indicated that introduction of solid foods had a marginal impact on the microbiome of EBF infants (24 enzymes overrepresented in EBF+S infants). In contrast, over 200 bacterial gene categories were overrepresented in non-EBF+S compared to non-EBF infants including several bacterial methyl-accepting chemotaxis proteins (MCP) involved in signal transduction. The identified differences between EBF and non-EBF infants suggest that breast milk may provide the gut microbiome with a greater plasticity (despite having a lower phylogenetic diversity) that eases the transition into solid foods.

Maternal Characteristics and Perception of Temperament Associated With Infant TV Exposure

OBJECTIVE: This study examines the development of television (TV) behaviors across the first 18 months of life and identifies maternal and infant predictors of infant TV exposure. METHODS: We used longitudinal TV exposure, maternal sociodemographic, and infant temperament data from 217 African-American mother-infant pairs participating in the Infant Care and Risk of Obesity Study. Longitudinal logistic models and ordered regression models with clustering for repeated measures across subjects adjusted for infant gender and visit were used to assess maternal and infant predictors of TV exposure and to test whether infants with both maternal and infant risk factors had higher odds of more detrimental TV exposure. RESULTS: Infants as young as 3 months old were exposed to an average of 2.6 hours of TV and/or videos daily, and nearly 40% of infants were exposed to >3 hours of TV daily by 12 months of age. Maternal TV viewing and maternal obesity and infant activity, fussiness, and crying were associated with greater infant TV exposure, whereas maternal education and infant activity were associated with having the TV on during most meals. Infants perceived as being more active or fussier had higher TV exposure, particularly if their mothers also had risk factors for higher TV exposure. CONCLUSIONS: Understanding the characteristics that shape TV exposure and its biological and behavioral sequelae is critical for early intervention. Maternal perception of infant temperament dimensions is related to TV exposure, suggesting that infant temperament measures should be included in interventions aimed at limiting early TV.

Pressuring and restrictive feeding styles influence infant feeding and size among a low-income African-American sample

The prevalence of overweight among infants and toddlers has increased dramatically in the past three decades, highlighting the importance of identifying factors contributing to early excess weight gain, particularly in high‐risk groups. Parental feeding styles and the attitudes and behaviors that characterize parental approaches to maintaining or modifying childrens eating behavior are an important behavioral component shaping early obesity risk.

Intergenerational impact of maternal obesity and postnatal feeding practices on pediatric obesity

The postnatal feeding practices of obese and overweight mothers may place their children at increased risk for the development of obesity through shared biology and family environments. This article reviews the feeding practices of obese mothers, describes the potential mechanisms linking maternal feeding behaviors to child obesity risk, and highlights the potential avenues of intervention. Strategies important for improving the quality of the eating environment and preventing the intergenerational transmission of obesity include supporting breastfeeding, improving the food choices of obese women, and encouraging the development of feeding styles that are responsive to hunger and satiety cues.

Who’s feeding baby? Non-maternal involvement in feeding and its association with dietary intakes among infants and toddlers ☆

This study examined non-maternal involvement in feeding during the first 2 years of life and its association with breastfeeding duration, early introduction of complementary foods, and dietary intakes of selected foods and beverages. Data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 low-income, African-American mother-infant dyads, followed from 3 to 18 months postpartum. Non-maternal caregivers (NMCs) were defined as persons involved in feeding an infant/toddler 50% or more of the total daily feedings. Use of any NMC and the type of NMC was tabulated for each study visit (3, 6, 9, 12, and 18 months). At each time point, more than half of all households reported a NMC. Fathers, grandmothers, and licensed childcare providers were the most common types of NMCs. In longitudinal models adjusted for confounding variables, NMC use was associated with a decreased likelihood of continued breastfeeding, and an increased likelihood of infants and toddlers consuming juice or whole fruit. Given the high prevalence of non-maternal involvement in feeding, interventions targeting multiple family members are warranted as they are likely to be more effective than those targeting the mother alone.

A Multicompartment Mathematical Model of Cancer Stem Cell-Driven Tumor Growth Dynamics

Tumors are appreciated to be an intrinsically heterogeneous population of cells with varying proliferation capacities and tumorigenic potentials. As a central tenet of the so-called cancer stem cell hypothesis, most cancer cells have only a limited lifespan, and thus cannot initiate or reinitiate tumors. Longevity and clonogenicity are properties unique to the subpopulation of cancer stem cells. To understand the implications of the population structure suggested by this hypothesis—a hierarchy consisting of cancer stem cells and progeny non-stem cancer cells which experience a reduction in their remaining proliferation capacity per division—we set out to develop a mathematical model for the development of the aggregate population. We show that overall tumor progression rate during the exponential growth phase is identical to the growth rate of the cancer stem cell compartment. Tumors with identical stem cell proportions, however, can have different growth rates, dependent on the proliferation kinetics of all participating cell populations. Analysis of the model revealed that the proliferation potential of non-stem cancer cells is likely to be small to reproduce biologic observations. Furthermore, a single compartment of non-stem cancer cell population may adequately represent population growth dynamics only when the compartment proliferation rate is scaled with the generational hierarchy depth.

Pathogenic and obesogenic factors associated with inflammation in Chinese children, adolescents and adults

Influenced by pathogen exposure and obesity, inflammation provides a critical biological pathway linking changing environments to the development of cardiometabolic disease. This study tests the relative contribution of obesogenic and pathogenic factors to moderate and acute CRP elevations in Chinese children, adolescents and adults.