Evaluation of Mother-Child Interactions During Feeding in Toddlers

Healthy feeding practices are particularly important in the early childhood due to rapid growth. Between 25 and 40% of healthy infants, and 80% of infants with a health problem have feeding problems. Almost 50% of mothers complain that at least one of their children eats inadequate amount of food. Feeding problems in early childhood includes prolonged, disruptive and stressful mealtimes, food refusal, lack of appropriate independent feeding, nocturnal eating, distraction to increase intake and prolonged breast or bottle feeding.

Eating behavior is a social process, also have a biological aspect. After excluding organic causes of feeding problems, family's attitude, roles and expectations must be examined. The determination of family responsibilities, feeding habits, life styles, perceptions and concerns can be guidance for understanding of feeding difficulties.

Mothers are primarily responsible for child care and feeding process traditionally. Many factors such as mother's knowledge about feeding, cultural believes, workload, media effect, psychological symptoms, child's temperament, time spent together are important points on feeding process.

Verbal and non-verbal communication methods can be learned by the observation of family members at the mealtime. Eating disorder of the child and depression of the mother can be related to each other. Anxiety level, anger, lack of empathy and also child's irritability and negative mood can disturb interaction during feeding. As a result of unresponsiveness to child's eating skills and signals, food refusal can be seen. Oppressive and restrictive style can trigger different pathological conditions related with feeding process.

Mother-child interactions in the etiology of feeding disorders has been investigated by a series of studies. The initial studies used nonorganic failure to thrive (NOFTT) as a diagnosis for children younger than 3 years of age who were unable to gain weight inadequately due to behavioral problems related to feeding. Some other "behavioral style" studies also suggested to use Mealtime Observation Schedule, DSM-IV (Diagnostic and Statistical Manual) Criteria, Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised Edition (DC:0-3R) as a diagnostic category of feeding disorder of infancy or early childhood. Feeding Scale developed by Chatoor is a useful tool to evaluate mother-child interactions during feeding.