Mealtime behaviors in families of infants and toddlers with cystic fibrosis☆
Received 27 July 2004; accepted 29 March 2005.
Abstract
Background
Parents of infants and toddlers with cystic fibrosis (CF) report problematic mealtime behaviors. Controlled studies that examine parent and child mealtime behaviors in infants and toddlers with CF using objective, observational procedures are needed to augment parent report findings and identify targets for effective interventions. We examined four hypotheses: 1) Parents of young children with CF would engage in more mealtime management behaviors to encourage eating than parents of control children. 2) Infants and toddlers with CF would engage in more problematic mealtime behaviors than control children. 3) Infants and toddlers with CF and their parents would demonstrate a greater frequency of behaviors incompatible with eating in the second half of the meal compared to the first half. 4) During slow meals, infants and toddlers would display a higher rate of mealtime behavior problems than during fast meals.
Methods
Thirty-four infants and toddlers with CF (M age=18.3±7.9 months) and a matched community sample of same age peers participated. Videotaped mealtimes were coded using the Dyadic Interaction Nomenclature for Eating (DINE).
Results
Parents of children with CF gave a higher rate and frequency of commands to eat than controls. All children displayed similar rates and frequencies of mealtime behaviors incompatible with eating. As the meal progressed, all children, regardless of illness status, displayed a greater frequency of behaviors incompatible with eating.
Conclusion
Direct observation of mealtime behaviors indicates that parents of infants and toddlers with CF engage in more mealtime management behaviors than parents of controls and that young children exhibit more behaviors incompatible with eating as the meal progresses. These findings highlight modifiable targets for behavioral and nutrition interventions that can be specifically designed for families of infants and toddlers with CF.
aCincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Sabin Education Center 4th Floor, ML: D-3015, 3333 Burnet Avenue, Cincinnati, Ohio, 45229-3039, United States
bThe University of Cincinnati College of Medicine, ML: D-3015, 3333 Burnet Avenue, Cincinnati, Ohio, 45229-3039, United States
cRhode Island Hospital, Brown University School of Medicine, Providence, Rhode Island, United States
dGraduate School of Public Health, San Diego State University, San Diego, California, United States
☆ This research was supported in part by grants R01 DK54915 and K24 DK59973 from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (to S.W.P.) and grant Z-117 from the National Cystic Fibrosis Foundation (to L.J.S.). Additional support was provided by USPHS Grant No. M01 RR 08084 from the National Center for Research Resources of the NIH. Data have been previously presented at the 16th North American Cystic Fibrosis Conference, October 3–6, 2002, New Orleans, LA [26].
ABSTRACT