Responsive feeding for reduction of infant obesity

Friday, January 31, 2020 13:00 - 13:45

‘Responsive feeding’ is a vital element of ‘Responsive Parenting’ and, generally, should embrace “responding promptly and appropriately to the baby’s needs” (Amy Brown, 2018).

It is a principle which runs like a common thread through both breast- and bottle-feeding; through the offering of weaning foods to children/toddlers; through to allowing teenagers to exercise choice over food type and intake in adolescence – assuming, in all of these cases, appropriate supervision by the parent/carer. In all these situations, the individual is seeking to exercise free control over the process of ingestion - thwarting or disrupting this control can lead, by an iatrogenic process, to ‘pathology’. So, for example, a failure to respond in a timely and appropriate manner to the breast-fed baby’s needs can commonly result in ‘breast milk insufficiency’, leading to under-nutrition; in contrast, habitually putting the ‘colicky’ infant to the breast can lead to ‘overfeeding’.

With regard to bottle-feeding, widespread acceptance that artificial formula has had an inappropriately high protein content (Alan Lucas, 2018), has meant that babies develop an inappropriate body composition leading to long-term morbidity (raised blood pressure). The concept of ‘fussy eating’ by toddlers is believed to have its origins in a “chronic mismatch of care-giver responsiveness to infant-feeding cues”. Finally, placing undue pressure on adolescents to eat, who may have a dysmorphic body image, can result in behavioural eating disorders (anorexia nervosa). Responsive feeding means giving the individual greater control over ingestion. So, given the universal commonality of these issues, the question is: Can responsive feeding throughout infancy and childhood lead to a reduction in childhood overweight/obesity (not ignoring the possibility that ‘unresponsive feeding’ can lead to under-nutrition)? I shall present my own thoughts surrounding the control of ingestion; look at scientific reviews of responsive feeding; ultimately signposting you to a key resource - the ‘Division of responsibility in feeding’ (Ellyn Satter, 2016), which, for me, crystallises key issues in this subject.

Birmingham & Manchester Speaker: Dr Mike Woolridge, Honorary Senior Lecturer, University College London

London Speaker: Bahee Van de Bor, Paediatric Dietitian, Great Ormond Street Hospital