Breastfeeding in Infancy and Food Intake in Preschool-Aged Children
Condition: Childhood Obesity; Breastfeeding
MeSH terms: Pediatric Obesity
Study type: Interventional

Summary: 
      The purpose of this study is to compare female, preschool-aged children breastfed during
      infancy to female, preschool-aged children bottle-fed during infancy in their ability to
      adjust calorie intake in response to internal signals of hunger and fullness. Children and a
      parent will come to two sessions, with the children given drinks that are either high or low
      in energy, and then consume a lunch following the drink. The parent will be present during
      the lunch. Greater ability to self-regulate intake is demonstrated when less energy is
      consumed at lunch following the high energy drink as compared to the lunch following the low
      energy drink. Lunches will be videotaped so that parental feeding styles (i.e., how the
      parent interacted with the child during lunch) can be examined. The primary hypotheses are:
      1.) the exclusively breastfed children will have higher self-regulation ability than the
      exclusively bottle-fed children, and 2.) the mothers of the exclusively breastfed children
      will demonstrate a parental feeding style characterized by less control and restriction than
      the mothers (or parent primarily responsible for child feeding) of the exclusively bottle-fed
      children.
    

Detailed description: 
      Research reports that children who were breastfed as infants have a decreased risk of
      becoming obese. However, it is not clear how breastfeeding may prevent the development of
      obesity. Breastfeeding may support the maintenance of sensitivity to internal hunger/fullness
      cues, which helps with self-regulating energy intake. Additionally, breastfeeding may
      facilitate the development of a parental feeding style low in control or restriction. This
      type of feeding style is also associated with greater ability to self-regulate energy intake.
      Bottle-feeding shifts feeding control to parents, and may lead to a parental feeding style
      high in control or restriction, impairing children's self-regulation abilities.

      The aims of this study are to determine in females aged 3-5 years if: 1.) breastfed children
      have greater energy self- regulation capabilities; 2.) parents of breastfed children
      demonstrate a parental feeding style characterized by less control or restriction; and 3.)
      children with the greatest energy self-regulation capabilities were breastfed and have
      parents with feeding styles lowest in control or restriction. It is hypothesized that female,
      preschool-aged children breastfed and/or parented with a feeding style low in control or
      restriction self-regulate intake better than females not breastfed and/or parented with a
      feeding style high in control or restriction.

      A within-subjects, counterbalanced design, using a standard preloading paradigm, will measure
      children's ability to self-regulate intake to preloads of differing energy densities.
      Children and a parent will participate in two trials, with children consuming preloads high
      and low in energy followed by a lunch in which energy intake is measured. Lunch will be
      videotaped so parental feeding style during the child's lunch can be coded for restriction
      and control. Results will provide information about potential mechanisms by which
      breastfeeding reduces the risk of obesity and obesity related diseases in children.
    

Intervention name(s): High Energy Density Preload; Low Energy Density Preload
Intervention type(s): Other; Other
Intervention description(s): Each child with a parent will attend a lunch session. In these sessions children will drink a liquid preload that is high in energy density and then they will consume an ad libitum lunch. The ad libitum lunch will be videotaped, and the videotapes will be coded for parental feeding styles; Each child with a parent will attend a lunch session. In these sessions children will drink a liquid preload that is low in energy density and then they will consume an ad libitum lunch. The ad libitum lunch will be videotaped, and the videotapes will be coded for parental feeding styles.
Allocation: Non-Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Basic Science
Keywords: Childhood Obesity; Breastfeeding; Bottle Feeding; Dietary Intake; Preload; Compensation; Parental Feeding Style