The Role of Self-Feeding in Food Acceptance Among Toddlers

Abstract

Abstract Objectives The ability to self-feed using utensils develops steadily from late infancy through toddlerhood. Here, we examine differences in food acceptance when infants and toddlers are self-fed versus caregiver-fed. Methods Caregivers (89% mothers) and their infants/toddlers (n = 57, 46% female, 86% black) aged 6–11 months (n = 13), 12–23 months (n = 29), and 24–36 months (n = 15) participated in laboratory visits that were video recorded. Children were offered both smooth and lumpy potato purees on a spoon. Caregivers were instructed to offer each texture until the child accepted 2 bites or refused 3 times. Trained coders watched the videos to determine who controlled each offer (caregiver, child, or both) and rated the child's acceptance of each offer (4-point scale: 0 = refusal, 1 = enforced, 2 = accept, 3 = anticipation). Acceptance was further dichotomized into refusal (0 or 1) or acceptance (2 or 3). Chi-square analyses were conducted to test the association between acceptance and who controlled the spoon offers for each bite, for each age group. Results Infants (6–11 months) were fed by their caregivers during 100% of offers. Younger toddlers (12–23 months) were fed the majority of offers by their caregiver (66%) and were the only age group to have shared control of some offers with their caregiver (4%). Older toddlers (24–36 months) were fed 50% of offers by their caregiver. An association was observed between acceptance and control of the spoon for both younger toddlers (χ2 = 16.21, P < .001) and older toddlers (χ2 = 51.22, P < .001). Both groups of children were more likely to accept smooth and lumpy potato purees when they had the opportunity to self-feed (Standardized residuals = 2.2 and 3.4) and were more likely to reject offers controlled by the caregiver (SR = −2.4, −3.7). Conclusions Both younger and older toddlers in our cohort were more likely to accept smooth and lumpy purees when they had the opportunity to self-feed compared to when they were fed by their caregivers. These findings suggest that giving children opportunities to self-feed may facilitate food acceptance during toddlerhood. Funding Sources None.