Feeding Behavior
Conditions
Keywords
Repeated Exposure, Infant/Toddler Feeding, Eating Behaviors
Brief summary
Decades of research have established that providing repeated exposure to new foods is the most robust strategy for promoting children's acceptance of new foods (1). However, there is little guidance on how best to translate this recommendation into everyday family life about how often to introduce children to new foods. We propose to conduct a proof-of-concept randomized trial that will evaluate three different schedules of repeated exposure to a novel vegetable, which will help to identify the optimal pacing of repeated exposure to promote children's acceptance (i.e., intake) of new vegetables. Here we define pacing as how often (every day, every few days, etc.) and across what interval of time (days, weeks, months) repeated exposure is effective for infants to learn to accept a novel food.
Detailed description
Child acceptance of a novel vegetable will be assessed at 4 periodic consumption tests. Participants will visit the Children's Eating Laboratory where caregivers will offer their infants the novel vegetable in the format of their choice (pureed, mashed, or cut into small pieces). These visits will occur at: 1) baseline; 2) 2 weeks to obtain an interim measure of acceptance; 3) 6 weeks to measure acceptance at the end of the exposure period, and 4) 3 months (approximately 6 weeks from the end of the exposure period) to measure longer-term acceptance. Caregivers will be asked not to feed their child less than 90 minutes before arriving for their visit, so that their child will be hungry when they are being offered food. The feeding sessions during each visit will be video recorded. Child acceptance of the novel vegetable will be measured by intake (consumption in grams) and rate of acceptance. The vegetable will be weighed before and after it is offered to calculate intake by the child. The videos will be coded by trained coders trained to reliability, who will code for the child's rate of acceptance of the novel food, which ranges from rejection of the food to eager anticipation of the bite (Hetherington et al. 2016 Food Qual Prefer; Nekitsing et al. 2016 Food Qual Prefer), and for child and caregiver behaviors (Barrett et al. 2021 Curr Dev Nutr). Caregivers will be provided the novel vegetable to offer their child at home. They will be asked to offer a small taste (2 small bites' worth or up to 3 rejections) at the intervals specified above. During the in-home exposure period, caregivers will be asked to keep a brief log of each offer of the novel food. These logs will include the method of food preparation (pureed or mashed vs. whole or in small pieces), whether the caregiver fed the child or the child fed themselves, whether the child tasted the food, and the caregiver's perception of the child's liking of the vegetable.
Interventions
BEHAVIORALRepeated Exposure
Caregivers will be asked to offer a novel vegetable to their infant/toddler 10 times at home according to the schedule of repeated exposure to which they are randomized.
Sponsors
Temple University
Vitamix Foundation
University of Colorado, Denver
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
9 Months to 12 Months
Healthy volunteers
Yes
Inclusion criteria
* Adult caregivers ≥ 18 years of age * Infants 9-12 months of age * Infants born ≥ 37 weeks gestational age * Infants have not been diagnosed with developmental delays, congenital or other medical conditions that may interfere with feeding (e.g., dysphagia).
Exclusion criteria
* Caregivers younger than 18 years of age * Caregivers do not speak English or Spanish * Caregivers do not live in the Denver Metro area * Infants who were born \< 37 weeks gestational age * Infants have been diagnosed with a developmental delay or congenital or medical condition that may interfere with feeding.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Consumption of the Novel Vegetable (Intervention Midpoint) | Baseline, Follow-up 1 | Change in the amount of novel food consumed (in g) |
| Change in Consumption of the Novel Vegetable (Intervention Endpoint) | Baseline, Follow-up 2 | Change in the amount of novel food consumed (in g) |
| Change in Consumption of the Novel Vegetable (Post-Intervention) | Baseline, Follow-up 3 | Change in the amount of novel food consumed (in g) |
| Change in Rate of Acceptance of the Novel Vegetable (Intervention Midpoint) | Baseline, Follow-up 1 | Difference in mean rate of acceptance between between follow-up and baseline. Acceptance is measured using an adaptation of the Feeding Infants: Behavior and Facial Expression Coding System (FIBFECS) on a 4-point scale from 0-3 where 0 = refusal and 3 = early acceptance of food. (Hetherington et al. 2016 Food Qual Prefer) |
| Change in Rate of Acceptance of the Novel Vegetable (Intervention Endpoint) | Baseline, Follow-up 2 | Difference in mean rate of acceptance between between end of intervention and baseline. Acceptance is measured using an adaptation of the Feeding Infants: Behavior and Facial Expression Coding System (FIBFECS) on a 4-point scale from 0-3 where 0 = refusal and 3 = early acceptance of food. (Hetherington et al. 2016 Food Qual Prefer) |
| Change in Rate of Acceptance of the Novel Vegetable (Post-Intervention) | Baseline, Follow-up 3 | Difference in mean rate of acceptance between between post-intervention follow-up and baseline. Acceptance is measured using an adaptation of the Feeding Infants: Behavior and Facial Expression Coding System (FIBFECS) on a 4-point scale from 0-3 where 0 = refusal and 3 = early acceptance of food. (Hetherington et al. 2016 Food Qual Prefer) |
Countries
United States
Contacts
Primary ContactKatherine J Barrett, PhD
Outcome results
None listed