By Kristen DiFilippo, MS, RDN, LDN & Dr. Susan Johnson, PhD
A mamma bird built her nest outside my office window. This week, her babies finally reached the size to peek their little heads above the edges of the nest, providing entertainment for my whole family. When mamma appears, three heads pop straight up with mouths wide open. The clear message: feed me! She responds, tirelessly flying back and forth to collect food, feed her babies, and repeat. I feel for this momma, remembering the signs my own children exhibited to express hunger and fullness before they could say a word. I remember the hunger cues, mouths wide open, wiggling into position to eat as tiny babies, or my youngest using sign language for “more” with as much expression as if she shouted the word. I recall the “gravity works” game, an indicator of fullness, where food dropped by my toddlers hit the floor every time. My children provided the signals; I provided structure and supportive response. Responsive feeding by caregivers, defined as prompt, developmentally appropriate response to cues of hunger and satiety is important to the development of self-regulation as children develop.1
Responsive feeding builds on the framework of responsive parenting.
Responsive parenting involves a relationship between child and caregiver including 4 steps2:
1) The caregiver provides
- emotional context
In responsive feeding this includes
- a pleasant environment
- limited distractions
- healthy, developmentally appropriate food
- predictable schedule
2) The child signals using
- motor actions
- facial expressions
3) The caregiver recognizes and responds in a way that is
- contingent on the child’s signals
- developmentally appropriate
In responsive feeding this includes
- encouraging and responding to hunger/satiety signs
- prompt response
- supportive, developmentally appropriate responses
4) The child experiences a predictable response and learns to trust that their needs will be met.
Children’s signals and experiences change throughout development. In the youngest babies, facial expressions, body movements and vocalizations all indicate hunger and satiety, while the child learns that their needs will be met.2 From 6-12 months, as children learn to sit on their own and self-feed, they learn to about new tastes, textures, and enjoyment of mealtimes.2 In the second year of life, as children develop words to signal hunger and satiety, they learn to self-feed and try new foods, and to ask for and expect help.2
Responsive feeding highlights a relationship between the caregiver and child. Caregivers who implement responsive feeding respect and encourage self-regulation on the part of the child in guiding the amount of food. This should not be misinterpreted as permissive feeding, where the child eats whatever they desire. Responsive feeding balances the caregiver’s responsibility to provide healthy food while appropriately responding to signals of both hunger and satiety. This relationship sets the stage for family mealtimes, eating behaviors, and child development throughout the years. The challenges of responsive feeding emerge when the caregiver must address competing demands—it’s not always convenient to be appropriately responsive! Another reality is that children’s cues can be subtle in the early stages of demand (e.g., infants mouthing their fingers and hands or soft grunts and vocalizations) but overwhelming later on if cues are missed (e.g. the full on meltdown).
Like the momma bird, parents work hard to provide the best for their children. In our next webinar, Dr. Johnson’s will explain the fundamental principles and behaviors associated with responsive feeding. Professionals working with families will learn to apply evidence-based knowledge to support feeding relationships.
- DiSantis KI, Hodges EA, Johnson SL, Fisher JO. The role of responsive feeding in overweight during infancy and toddlerhood: a systematic review. International Journal of Obesity (2011) 35, 480–492; doi:10.1038/ijo.2011.3.
- Black MM, Aboud FE. Responsive Feeding Is Embedded in a Theoretical Framework of Responsive Parenting. The Journal of Nutrition. 2011;141(3):490-494. doi:10.3945/jn.110.12997