Abstract
Responsive feeding has been identified as important in preventing overconsumption by infants. However, this is predicated on an assumption that parents recognise and respond to infant feeding cues. Despite this, relatively little is understood about how infants engage parental feeding responses. Therefore, the aim of this systematic review was to identify what is known about infant communication of hunger and satiation and what issues impact on the expression and perception of these states. A search of Medline, CINAHL, Web of Science, PsycINFO, Science Direct and Maternal and Infant care produced 27 papers. Eligibility criteria included peer reviewed qualitative and/or quantitative publications on feeding behaviours, hunger, and satiation/satiety cues of typically developing children in the first 2 years of life. Papers published between 1966 and 2013 were included in the review. The review revealed that feeding cues and behaviours are shaped by numerous issues, such as infants' physical attributes, individual psychological factors and environmental factors. Meanwhile, infant characteristics, external cues and mothers' own characteristics affect how feeding cues are perceived. The existing literature provides insights into many aspects of hunger and satiation in infancy; however, there are significant gaps in our knowledge. There is a lack of validated tools for measuring hunger and satiation, a need to understand how different infant characteristics impact on feeding behaviour and a need to extricate the respective contributions of infant and maternal characteristics to perceptions of hunger and satiation. Further research is also recommended to differentiate between feeding driven by liking and that driven by hunger.
Highlights
Childhood obesity is prevalent in developed countries (Ogden et al 2012; Wang & Lobstein 2006), and research has focussed on factors that might increase obesity risk in children
An initial scoping exercise was conducted to establish whether reviews had been completed previously on infant feeding cues
This study provides further evidence that developmental stage impacts on behaviours associated with hunger and satiation
Summary
Childhood obesity is prevalent in developed countries (Ogden et al 2012; Wang & Lobstein 2006), and research has focussed on factors that might increase obesity risk in children. Some of the factors identified far include parental body mass index (BMI), birthweight, early adiposity, weight gain during the first year of life and maternal feeding practices (Dev et al 2013; Reilly et al 2005). Several reviews indicate that maternal feeding practices may increase obesity risk by influencing the early entrainment of appetite control (De LauzonGuillain et al 2012; Disantis et al 2011; Hurley et al 2011). ‘Responsive’ mothers are sensitive to hunger and satiation cues and respond to these appropriately, while discordant maternal responses are a proposed risk factor for obesity. Worobey et al (2009) found lower maternal sensitivity to feeding cues at 6 months predicted infant weight gain between 6 and 12 months. DiSantis et al (2011) suggested that a third kind of discordant response, maternal pressure to eat, may increase obesity risk
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