Does Distraction During Bottle Feeding Promote Over-Feeding?

Individuals who are distracted by surrounding stimuli (e.g., watching television, using a tablet and/or computer, etc.) during meals tend to consume more food and energy than those who are not distracted. This is because distraction during meals decreases individuals’ awareness of their internal states of hunger and satiation. It is unclear whether this phenomenon carries over to maternal distraction during infant feeding. While there is existing literature on responsive infant feeding, and its beneficial impacts on infant feeding outcomes, the present study is the first to assess maternal distraction during the mother-infant feeding interaction and its impact on responsive feeding and infant formula/milk consumption. This secondary analysis of a bottle-feeding study had three specific aims: 1) to compare amounts of formula/milk consumed between infants of distracted mothers vs. infants of non-distracted mothers with the hypothesis being that the former would consume more than the latter; 2) to compare the degree of maternal responsiveness to infant cues between distracted mothers versus non-distracted mothers with the hypothesis being that the former would score lower on the sensitivity to cues and responsiveness to infant distress than the latter; 3) To explore predictors of distraction during the feeding interaction. Mothers and their 0 to 24-week-old bottle-feeding infants (N=28) visited the laboratory for feeding observations. Mothers were video-recorded while feeding their infants as they normally would at home. Infant intakes were assessed by weighing the bottles before and after the feedings. Maternal distraction was defined as: 1) looking somewhere other than at the infant for more than 75% of the feeding; 2) using a cell-phone; 3) conversing with someone other than their infant; or 4) falling asleep. To explore predictors of maternal distraction, mother and infant anthropometrics were measured, and mothers completed questionnaires about their feeding styles, infants’ temperaments, and own eating habits. Finally, video records were scored using the Nursing Child Assessment Satellite Training (NCAST) Parent-Child Interaction (PCI) Feeding Scale, which provided measures of mothers’ sensitivity to infant cues and responsiveness to infant distress. The difference in intakes for infants of distracted (n=8) vs. not distracted (n=20) mothers did not reach significance (p=0.24). There was, however, a trend towards a significant interaction between maternal distraction and infant age (p=0.06): the association between maternal distractedness and intake for infants over 10.9 weeks of age approached significance (distracted: 174.4 ± 23.0 ml vs. non-distracted: 126.7 ± 14.5 ml; p = 0.09), whereas there was no association between maternal distraction and intake for infants younger than 11 weeks of age (p=0.99). Maternal distraction and infant intake was also modified by two dimensions of infant temperament: orienting/regulation capacity (p=0.03) and surgency (p=0.04). When infants had low levels of orienting/regulation capacity, those whose mothers were not distracted consumed significantly less than those whose mothers were distracted (92.4 ml ± 13.8 ml vs. 177.1 ± 33.8 ml, p=0.03). When infants had high levels of orienting/regulation capacity, there was no difference in intake between infants with distracted mothers vs. those with non-distracted mothers. Infants with low levels of surgency who had non-distracted mothers consumed significantly less than those whose mothers were distracted (78.4 ml ± 14.3 ml vs. 140.6 ml ± 22.5 ml, p=0.03). For infants with high levels of surgency, there was no effect of maternal distraction on infant intake. A higher proportion of distracted mothers scored lower on the sensitivity to cues subscale of NCAST feeding scale than non-distracted mothers (p=0.04, Fisher’s Exact Test). Additionally, a significantly greater proportion of distracted mothers were single (p=0.05), and there was a trend towards a significantly higher proportion of distracted women classified as low-income compared to non-distracted mothers (p=0.07). Furthermore, distracted mothers tended to have higher levels of pressuring (p=0.09) and lower levels of responsive feeding styles compared to non-distracted mothers (p=0.07). In conclusion, maternal distraction during bottle-feeding may increase the risk of overfeeding infants who are older, who have poor self-regulatory capacity, and who are low in surgency/extraversion. The findings of this study also highlighted certain maternal characteristics associated with maternal distraction. Further research with experimental designs and larger samples is needed to fully understand the predictors and effects of maternal distraction on infant feeding.M.S., Human Nutrition -- Drexel University, 201