Purpose: Understanding feeding development is essential for improving the targeted management of pediatric feeding disorder (PFD), but information is scarce on how infants develop complementary feeding skills in their natural environments. This cross-sectional observational study was a first step toward (a) assessing the feasibility of characterizing infant feeding experiences in the home environment and (b) determining the concurrent predictors of infant complementary feeding skills using a dynamic systems approach. Method: Thirty-six 6- to 8-month-old infants and their caregivers participated; this sample was loaded with 11 infants considered “at risk” of developing feeding disorders due to experience in the neonatal intensive care unit. Feeding was assessed with the Oral Feeding Skills Scale (OFS-S) and an eating efficiency measure, extracted from caregiver-recorded videos of typical meals at home. Caregivers completed surveys and interviews to qualitatively characterize the infants' typical home feeding environment and infant experiences. Developmental covariates were assessed via standardized tests, and analyses included hierarchical logistic regressions. Results: All enrolled families completed all components of data collection, and data analysis was found to be valid and reliable using caregiver-recorded methods in the home setting. Infants demonstrated a wide range of feeding experiences and variable complementary feeding skills (OFS-S scores of 15.67–52.67), with significant differences between risk groups ( t = 4.39, p < .001); infants in the at-risk group demonstrated less skills and more variability. Risk group ( p < .00015) and weeks of feeding experience ( p < .0026) were the best concurrent predictors of infant oral–motor complementary feeding skills at 6–8 months of age. Conclusions: This study provides new evidence that it is feasible to observe infant complementary feeding skills in the home environment, and infants at risk for feeding disorders demonstrate complementary feeding skills different from those of low-risk peers. Future studies should include more infants in a longitudinal design to tease out influences on development, with the aim of early identification and treatment of PFD. Supplemental Material: https://doi.org/10.23641/asha.32034999
Arkenberg et al. (Tue,) studied this question.