title: [Early restrictive feeding disorders: Quantitative assessment of parent/infant feeding interactions].
abstract: BACKGROUND
  Interest in the study of early feeding disorders (FD) has steadily increased during recent decades. During this period, research described the importance of the transactional relationships and the complex interplay between caregiver and child over time. On the basis of the previous studies, our study tried to explore the associations between the characteristics of the parents and the temperamental characteristics of the infants with early FD.
  
  
  OBJECTIVE
  A first aim of the present study was to show if parental perception of child temperament (including ability for arousal self-regulation) and parental characteristics (emotional and eating attitudes) are associated with early FD. A second aim was to identify emotional/behavioral difficulties in children with early FD by comparing children with a normal development and children with a diagnosed FD, and to investigate whether there are any correlations between parental emotional and feeding characteristics and a child's eating and emotional-behavioral development. A final aim was to explore if feeding conflict is bound to both infant ability for arousal self-regulatation and caregiver emotional status during meals.
  
  
  METHODS
  Participants: 58 clinical dyads (children aged 1-36 months) and 60 in the control group participated in the study. The sample of 58 infants and young children and their parents was recruited in a pediatric hospital. They were compared to healthy children recruited in several nurseries.
  
  
  METHODS
  all parent-child pairs in the clinical sample were observed in a 20-minute video-recording during a meal using the procedure of the Chatoor Feeding Scale. After the videotaping, parents completed a battery of self-report questionnaires assessing their child's and their own psychological symptom status.
  
  
  METHODS
  Child's malnutrition assessment was based on the Waterlow criteria. The Child Behavior Checklist (CBCL 1½-5) was used to assess a child's emotional/behavioral functioning. The Infant Behavior Questionnaire-Revised (IBQ-R), a widely used parent-report measure of infant temperament, was used to identify the structure of infant temperament. The Eating Attitude Test-40, a self-report symptom inventory, was used to identify concerns with eating and weight in the adult population. The Chatoor Feeding Scale was used to assess mother-child feeding interactions during a meal based on the analysis of the videotaped feeding session.
  
  
  RESULTS
  Analyses revealed that children with FD did not have a difficult temperament, especially no disability for arousal of self-regulatation, but their emotional-behavioral functioning is characterized by internalizing problems. Analyses of the EAT-40 showed that mothers of the children diagnosed with FD had significantly higher scores than mothers of the control sample; it means these mothers showed more dysfunctional eating attitudes. In addition, meals were characterized by negative effects in parents in the clinical group. When compared to the control sample, the feeding interactions between children with FD and their parents were characterized by low dyadic reciprocity, high maternal non-contingency, great interactional conflict and struggles with food. However, no significant correlation emerged either between the severity of malnutrition in infants or the conflict during feeding.
  
  
  CONCLUSIONS
  Our study confirms the relations established in previous research. Finally, future longitudinal studies are needed to further clarify and investigate others factors that may be involved in early feeding disorders.
authors.affiliation: Service universitaire de psychiatrie de l'enfant et de l'adolescent, CHU de Toulouse, 31059 Toulouse cedex 9, France. Electronic address: amelie.bion@aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Bion
authors.affiliation: Université Toulouse Le Mirail, 31000 Toulouse, France.
authors.forename: T
authors.initials: T
authors.lastname: Cascales
authors.affiliation: Unité de gastro-entérologie et nutrition, département médicochirurgical de pédiatrie, hôpital des Enfants, CHU de Toulouse, 31059 Toulouse cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Dubedout
authors.affiliation: Service de psychiatrie de l'enfant et de l'adolescent, GHU Pitié-Salpêtrière-Charles-Foix, 75651 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Bodeau
authors.affiliation: Unité de gastro-entérologie et nutrition, département médicochirurgical de pédiatrie, hôpital des Enfants, CHU de Toulouse, 31059 Toulouse cedex 9, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Olives
authors.affiliation: Service universitaire de psychiatrie de l'enfant et de l'adolescent, CHU de Toulouse, 31059 Toulouse cedex 9, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Raynaud
mesh_terms: D000328:Adult; D001143:Arousal; D001290:Attitude; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000150:complications / Q000523:psychology; D002675:Child, Preschool; D003220:Conflict, Psychological; D004435:Eating / Q000523:psychology; D004644:Emotions; D019959:Feeding and Eating Disorders of Childhood / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009034:Mother-Child Relations; D009483:Neuropsychological Tests; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D013694:Temperament
keywords: Child temperament; Conflit alimentaire; Dysfunctional interactions; Early feeding disorders; Feeding scale; Food refusal; Nourrisson; Parent emotions; Tempérament; Troubles du comportement alimentaire restrictif précoce; Échelle d’alimentation