Sleep SAAF responsive parenting intervention improves mothers' feeding practices: a randomized controlled trial among African American mother-infant dyads

Erika Hernandez; Justin A Lavner; Amy M Moore; Brian K Stansfield; Steven R H Beach; Jessica J Smith; Jennifer S Savage

doi:10.1186/s12966-022-01366-1

Sleep SAAF responsive parenting intervention improves mothers' feeding practices: a randomized controlled trial among African American mother-infant dyads

Int J Behav Nutr Phys Act. 2022 Oct 1;19(1):129. doi: 10.1186/s12966-022-01366-1.

Authors

Erika Hernandez¹, Justin A Lavner², Amy M Moore¹, Brian K Stansfield³, Steven R H Beach^{4

5}, Jessica J Smith⁵, Jennifer S Savage¹

Affiliations

¹ Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA, USA.
² Department of Psychology, Psychology Building, University of Georgia, Athens, GA, 30602-3013, USA. lavner@uga.edu.
³ Department of Pediatrics, Medical College of Georgia, Augusta, GA, USA.
⁴ Department of Psychology, Psychology Building, University of Georgia, Athens, GA, 30602-3013, USA.
⁵ Center for Family Research, University of Georgia, Athens, GA, USA.

Abstract

Background/objective: Parents shape children's early experiences with food, influencing what is served, children's food choices, and how much children eat. Responsive parenting (RP) interventions such as INSIGHT have improved maternal infant feeding practices, but have only been tested among predominantly White families. This secondary analysis of data from the Sleep SAAF (Strong African American Families) RCT tests the effects of an RP intervention designed to prevent rapid infant weight gain on African American mothers' infant feeding practices.

Methods: Primiparous African American mother-infant dyads (n = 194) were randomized to an RP or safety control intervention delivered by community research associates at infant age 3 and 8 weeks. At 16 weeks, mothers completed the Babies Need Feeding questionnaire, the Infant Feeding Styles Questionnaire, and the Babies Need Soothing questionnaire. Logistic regression and general linear models examined the effect of study group on infant feeding practices. Moderation analyses explored whether effects varied by feeding mode (any breast milk versus exclusive formula), maternal age (≥ 20 years versus < 20 years), and maternal pre-pregnancy BMI (with obesity versus not).

Results: RP mothers reported more responsive feeding (p = 0.005, partial η² = 0.02), lower likelihood of using beverages other than breast milk/formula to soothe their infant (p = 0.01, OR = 0.42, 95% CI [0.2-0.8]), and less pressure with cereal than control mothers (p = 0.09, partial η² = 0.02). RP mothers also reported less pressure to finish/soothe than controls (p = 0.007, partial η² = 0.04); feeding mode (B = 0.74, p = 0.003) and maternal age (B = 0.53, p = 0.04) moderated this effect. There were no significant group differences in bottle-feeding practices (e.g., adding cereal to bottle, using an appropriate nipple/bottle size), or in context-based or emotion-based food to soothe.

Conclusions: Responsive parenting education influenced some feeding practices of African American mothers. Mothers reported using less pressure, a control-based feeding practice, and more responsive feeding than controls.

Trial registration: Sleep SAAF: A Strong African American Families Study. www.

Clinicaltrials: gov NCT03505203. Registered 3 April 2018.

Keywords: African American; Childhood obesity; Feeding practices; Infancy; Prevention; Responsive parenting.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Adult
Black or African American
Child
Feeding Behavior
Female
Humans
Infant
Infant, Newborn
Mothers
Parenting*
Pediatric Obesity* / prevention & control
Pregnancy
Sleep
Surveys and Questionnaires
Young Adult

Associated data

ClinicalTrials.gov/NCT03505203

Grants and funding

R01 DK112874/DK/NIDDK NIH HHS/United States