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Relation of maternal-infant feeding interaction with maternal stressors and distress in Bangladesh

Amy L. Frith, MS, MPH, Nutritional Sciences Division, Cornell University, Savage Hall, Ithaca, NY 14853-6301, 607-273-6369, aft3@yahoo.com, Edward A. Frongillo, PhD, Division of Nutritional Sciences, Cornell University, Savage Hall, Ithaca, NY 14853-6301, Ruchira T. Naved, PhD, Public Health Sciences Division, ICDDR,B: Centre for Health and Population Research, G.P.O. Box 128, Dhaka, Bangladesh, and Mary W. Byrne, PhD, School of Nursing, Columbia University, SON 630 W 168 ST, GB 347, New York, NY 10027-6902.

Previous research suggests that stress may affect maternal-infant interaction in a poor population. Given the importance of maternal-infant interaction in shaping the well-being of children, understanding which factors lower the quality of interaction is needed. We examined the relation of stressors and distress with quality of maternal-infant feeding interaction. As part of the MINIMat nutrition intervention study in Bangladesh, 120 mother-infant pairs were observed in the home at 3.5-4.0 months to assess quality of feeding interaction using the NCAST feeding scale. This scale is based on a checklist of 76 items forming four maternal and two infant subscales, and 18 contingency items. Internal consistency, test-retest reliability, and criterion validity were assessed. Questionnaires were administered to mothers to assess stressors (food insecurity and interpersonal conflict) and distress. Analysis of variance was used. Lower quality of feeding interaction was related to higher food insecurity (p < 0.01), greater interpersonal conflict (p < 0.05), and increased distress (p < 0.05). Interpersonal conflict was related to reduced maternal and infant modes of communication (p < 0.1), increased maternal negative behavior (p < 0.05), and specific maternal self-reported feeding cues (p < 0.05). Increased distress was related to reduced maternal and infant verbalizations (p < 0.05). Differences in quality of feeding interaction with stressors were larger than differences across populations. This study demonstrates the importance of assessing feeding interaction, the potential impact of stressors and distress in lowering the quality of feeding interaction, and the suitability of the NCAST feeding scale in a developing country.

Learning Objectives: At the end of the session, the learner in this session will gain understanding about the range of maternal and infant communication and behaviors during feeding in a non-Western population. The learner will be able to

Keywords: Infant Health, Stress

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Student Papers in Child and Family Health

The 132nd Annual Meeting (November 6-10, 2004) of APHA