Feeding interactions: Failure to thrive, feeding problem and normal babies

Abstract

Sixteen infants, six with Non-Organic Failure to Thrive (NFTT), five control subjects and five infants with behavioral feeding problems but no significant weight loss, and their mothers, were videotaped from behind a one-way mirror during a feeding period. Feeding interactions between mother and baby were assessed with the Chatoor (1988) Mother-Infant/Toddler Feeding Scale, by a rater blind to the age and diagnosis of the infant. A Bayley Mental Developmental Index (MDI) was also administered.;Significant differences were found between the three groups for the Bayley and for three out of five subscales on the Chatoor feeding scale: Dyadic Reciprocity, Dyadic Conflict, and Bargaining About Food. Feeding Problem dyads demonstrate significantly less Dyadic Reciprocity and more Dyadic Conflict than the Control group. NFTT dyads demonstrate significantly more bargaining than Feeding Problem dyads.;Of particular interest is the finding that NFTT appears to be a distinctly different syndrome from Feeding Problem. The two are distinguished mostly on the basis of their bargaining behavior: Feeding Problem dyads bargain more than NFTT dyads. Normal babies perform significantly better on the Bayley scores Mental Developmental Index than NFTT babies.;This study validates the Chatoor feeding scale for use with NFTT and Feeding Problem dyads. In addition, various feeding scale modifications were suggested: refined item definitions, some behavior frequencies for scoring categories, a stringent reliability procedure and the recommendation that all or some of the items on the Maternal Non-Contingency subscale be deleted.