The relationship of a mother's working model of feeding to her feeding behaviour.

Abstract

This study aimed to examine the difference the attunement of a mother's working model of feeding to her infant makes for her positive feeding affect and behaviour, accounting for infant and mother conditions. The concept of a mother's working model of feeding is derived from attachment theory. Caregiving, including feeding, is a component of this theory. The conditions that may influence the attunement of a mother's working model of feeding to her infant include infant birth maturity status (premature, full-term), age at assessment, and robustness, indexed by weight-for-age z score (WAZ). Mother conditions include symptoms of depression and feeding practice (breast feeding or exclusive bottle feeding). Participants in this longitudinal study were 99 mothers and their infants (47 full-term, 52 premature, very low birth weight). After written informed consent was given, home assessments were made when infants were approximately 1, 4, 8 and 12 months old (adjusted age for premature infants). Working model attunement was assessed with a video-assisted interview. A mother's positive affect and behaviour, including sensitivity and responsiveness, were rated from videotaped feeding interaction. Repeated measures analysis with a general linear mixed model showed a significant positive relationship with positive affect and behaviour for both working model attunement and the WAZ score and a significant negative relationship for symptoms of depression. Neither birth maturity status, infant age, nor feeding practice had a significant effect on mother's positive affect and behaviour during feeding. Nurses' efforts to enhance the attunement of a mother's working model of feeding may help mothers feed with greater positive affect and behaviour. Further study of how the attunement of a mother's feeding expectations and intentions are related to her symptoms of depression and with what she makes of the infant's growth and well-being is needed. The theoretical model needs testing with infants from the entire premature population.