Background: Parents of infants and toddlers with cystic fibrosis (CF) report problematic mealtime behaviors. Controlled studies that examine parent and child mealtime behaviors in infants and toddlers with CF using objective, observational procedures are needed to augment parent report findings and identify targets for effective interventions. We examined four hypotheses: 1) Parents of young children with CF would engage in more mealtime management behaviors to encourage eating than parents of control children. 2) Infants and toddlers with CF would engage in more problematic mealtime behaviors than control children. 3) Infants and toddlers with CF and their parents would demonstrate a greater frequency of behaviors incompatible with eating in the second half of the meal compared to the first half. 4) During slow meals, infants and toddlers would display a higher rate of mealtime behavior problems than during fast meals.
Methods: Thirty-four infants and toddlers with CF (M age = 18.3 +/- 7.9 months) and a matched community sample of same age peers participated. Videotaped mealtimes were coded using the Dyadic Interaction Nomenclature for Eating (DINE).
Results: Parents of children with CF gave a higher rate and frequency of commands to eat than controls. All children displayed similar rates and frequencies of mealtime behaviors incompatible with eating. As the meal progressed, all children, regardless of illness status, displayed a greater frequency of behaviors incompatible with eating.
Conclusion: Direct observation of mealtime behaviors indicates that parents of infants and toddlers with CF engage in more mealtime management behaviors than parents of controls and that young children exhibit more behaviors incompatible with eating as the meal progresses. These findings highlight modifiable targets for behavioral and nutrition interventions that can be specifically designed for families of infants and toddlers with CF.