Overall Research Project Description Infant feeding practices include both what infants are fed and how infants are fed.1-3 Breastfeeding for longer durations, the introduction of complementary foods after 4 months of age, and responsive feeding contribute to healthy infant growth.2,4,5 Healthy infant growth is associated with healthy weight later in childhood.6,7 Responsive feeding occurs when a caregiver learns, recognizes, and responds promptly and appropriately to the infant’s cues of hunger and satiation.8 Theory posits that responsive feeding promotes awareness of internal cues for the infant, and thus, self-regulation that contributes to healthy eating and weight trajectories across developmental stages. Interventions to promote responsive feeding in mother-infant dyads have proven successful in promoting responsive feeding,9,10 healthy infant weight gain,10,11 and infant eating behaviors.12-14 Prior work supports that mothers who breastfeed are more likely to engage in responsive feeding.15,16 A novel premise of the current proposal (Aim 1) is that a bidirectional association between breastfeeding and responsive feeding may exist (Figure 1). The latter finding would support the value of training mothers in responsive feeding techniques to increase the likelihood and duration of breastfeeding.
The Candidate and her team developed an individualized responsive feeding intervention, Learning Early Infant Feeding Cues (LEIFc). LEIFc comprises brief videos, written material, and face-to-face coaching sessions guided by a validated coaching approach called SS-OO-PP-RR (or “super,” Setting the Stage, Observation and Opportunities to Embed, Problem Solving and Planning, Reflection and Review).17 A feasibility and fidelity study of the LEIFc intervention, funded by the Candidate’s Dean’s Research Award, is currently underway with 25 dyads enrolled. The proposed study builds on this work by adding a participatory, mixed methods design to evaluate and refine the LEIFc intervention (Aims 2 and 3).
Aim 2. Integrate quantitative data and qualitative data from the current feasibility and fidelity study using mixed methods to evaluate the LEIFc intervention. The quantitative and qualitative data collected in the current study will be examined using the convergent design of mixed methods research. We hypothesize that the study is feasible and the fideility of the study could use refinement to meet needs of vulnerable mother-infant dyads.
Aim 3. Employ a participatory approach to refine the LEIFc intervention to maximize its benefit and relevance to vulnerable mother-infant dyads. Using results from Aims 1 and 2, along with input from a community advisory panel, the LEIFc intervention will be refined and a research protocol for a pilot randomized controlled trial (RCT) to test the refined intervention will be designed. We hypothesize that the LEIFc intervention will be feasible to implement once revised and will meet the needs of vulnerable mother-infant dyads to improve infant feeding practices.