Mother-toddler feeding interactions in preterm and full-term dyads: the influence of maternal and infant factors

The literature has highlighted that feeding disorders of infancy and early childhood are associated with the mother-child relationship. Premature children seem exceptionally vulnerable for the development of feeding difficulties, however literature lacks of studies on preterm mother-child feeding interactions, especially during toddlerhood. Aim of the study was to explore, through a transactional multi–risk model, the quality of mother-child feeding interactions between 18 and 30 months comparing preterm and full-term dyads. The contribution of maternal (depression, anxiety) and infant (development, breastfeeding, weaning, reflux) factors was also considered. A total of 69 mother-child dyads (44 preterm and 25 full-term) were assessed at 18, 24 and 30 months at the Psychodynamic Laboratory (Cesena). During each assessment 20 minutes of mother-child feeding interactions were video recorded and later coded through the SVIA (Ammaniti et al., 2006), the child’s development was assessed through the Griffiths scales (Griffith, 1996) and mothers were administered the BDI-II (Beck & Steer, 1996) and the STAI (Spielberger, 1983). Data on child’s breastfeeding, weaning, and reflux were gathered through an ad hoc questionnaire. Preterm dyads showed greater negative maternal affective state, greater interactional conflict and less dyadic reciprocity than full-term dyads from 18 to 30 months. Moreover, interactional conflict and maternal affective state during meals were negatively influenced by maternal depression, while low dyadic reciprocity was associated with low child’s development. Last, greater child’s food refusal was related to low child’s development, lack of breastfeeding, and presence of reflux. These findings indicate that attention should be paid to support mother-child feeding interactions during toddlerhood in preterm populations so to foster the mother-child relationship and promote the child’s healthy eating behaviour.