Parental Feeding Strategies and Outcomes During Complementary Food Introduction Among Preterm Infants at 12 Months Corrected Age

OBJECTIVE: The introduction to complementary food is an important stage, particularly for preterm infants and their parents as they navigate a changing feeding relationship. Parental feeding strategies during this period can influence long-term feeding outcomes, but the influence of specific strategies on later feeding skills and feeding problem symptoms is unknown. METHOD: Parents of preterm infants completed surveys about their infant's feeding at regular intervals from 1 to 12 months of age. At each time point, parents reported on their use of feeding strategies and their infants' feeding skills (Child Oral and Motor Proficiency Scale) and feeding problem symptoms (Pediatric Eating Assessment Tool). Patterns of parental strategy use across the early complementary feeding period were examined and associations with feeding skills and problems at 12 months corrected age was assessed. RESULTS: Seventy-four parents completed the surveys. Frequency and type of strategies used changed over time. Four patterns of parental strategy use emerged: low-moderate, schedule dominant, dual dominant, and modification dominant. Parental use of 2 or more types of strategies at relatively high levels was associated with more feeding problem symptoms at 12 months but not feeding skills. CONCLUSION: Parents of preterm infants use different strategies during the complementary feeding period to navigate their infant's feeding, with potential implications for later feeding problems. Future research should explore causal mechanism behind parental strategy use and feeding problem symptoms through longitudinal analyses and investigate how parental perceptions and decision-making regarding mealtime strategy use evolve over the first year of life.