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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Nov 16, 2022
Date Accepted: Dec 23, 2022

The final, peer-reviewed published version of this preprint can be found here:

Development of an Individualized Responsive Feeding Intervention—Learning Early Infant Feeding Cues: Protocol for a Nonrandomized Study

Bahorski J, Romano M, McDougal JM, Kiratzis E, Pocchio K, Paek I

Development of an Individualized Responsive Feeding Intervention—Learning Early Infant Feeding Cues: Protocol for a Nonrandomized Study

JMIR Res Protoc 2023;12:e44329

DOI: 10.2196/44329

PMID: 36853761

PMCID: 10015354

Development of an Individualized Responsive Feeding Intervention, Learning Early Infant Feeding Cues (LEIFc): Protocol for a Non-Randomized Study

  • Jessica Bahorski; 
  • Mollie Romano; 
  • Julie May McDougal; 
  • Edie Kiratzis; 
  • Kinsey Pocchio; 
  • Insu Paek

ABSTRACT

Background:

Responsive infant feeding (RIF) occurs when a parent recognizes their infant’s cues of hunger or satiety and responses promptly to these cues. RIF is known to promote healthy dietary patterns and infant weight gain, and is recommended as part of the Dietary Guidelines for Americans. However, the use of RIF can be challenging for many parents. Research is needed to assist caregivers recognize infant hunger/satiety cues and overcome barriers to using RIF.

Objective:

The Learning Early Infant Feeding Cues (LEIFc) intervention was designed to fill this gap by using a validated coaching approach, SS-OO-PP-RR (“super,” Setting the Stage, Observation & Opportunities, Problem Solving & Planning, Reflection & Review), to promote RIF. Guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, this study aims to test the feasibility and fidelity of the LEIFc intervention in a group of mother-infant dyads.

Methods:

This pre-post quasi-experimental study with no control group will recruit mothers (N=30) in their 3rd trimester (28 weeks and beyond) of pregnancy from community settings. Study Visit 1 will occur prenatally in which written and video material on infant feeding and infant hunger and satiety cues is provided. Demographic information and plans for infant feeding are also collected prenatally via self-report surveys. Use of RIF via subjective (survey) and objective (video) measures is collected pre- (Study Visit 2, 1 month postpartum) and post- (Study Visit 5, 4 months postpartum) intervention. Coaching on RIF during a feeding session is provided by a trained interventionist using the SS-OO-PP-RR approach at Study Visits 3 (2 months postpartum) and 4 (3 months postpartum). Infant feeding practices are collected via survey and infant weight and length are measured at each postpartum study visit. Qualitative data on the LEIFc intervention are provided by the interventionist and mother. Infant feeding videos will be coded and tabulated for instances of infant cues and maternal responses. The subjective measure of RIF will also be tabulated. Analyses for use of RIF pre-post intervention will be conducted using matched t-tests. Qualitative data will be examined to guide refinement of the intervention.

Results:

This study initially began in spring 2020, but was halted by the COVID-10 pandemic. With new funding, recruitment, enrollment, and data collection began in April 2022 and will continue until April 2023.

Conclusions:

After refinement, the LEIFc intervention will be tested in a pilot randomized controlled trial. The long-term goal is to implement LEIFc in the curricula of federally funded maternal-child home visiting programs who serve vulnerable populations; those that often have infant feeding practices that do not align with recommendations and are less likely to use RIF.


 Citation

Please cite as:

Bahorski J, Romano M, McDougal JM, Kiratzis E, Pocchio K, Paek I

Development of an Individualized Responsive Feeding Intervention—Learning Early Infant Feeding Cues: Protocol for a Nonrandomized Study

JMIR Res Protoc 2023;12:e44329

DOI: 10.2196/44329

PMID: 36853761

PMCID: 10015354

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