Infant Feeding Behavior and Caretaker-Infant Relationships in Black Families

INTRODUCTION In the past decades, knowledge of the behavioral capacities of the newborn infant has increased dramatically. Infant feeding behavior represents one of the most well-developed behavioral systems in the human newborn infant. The mechanisms of feeding behavior are established prenatally, and organized feeding patterns can be observed in the first twenty-four hours after birth (Brazelton, 1987). Feeding also serves as the context in which caretaker-infant interactions and cognitive skills in the newborn develop (Divitto and Goldberg,1983). Thus, feeding interactions provide an important foundation on which subsequent development in the infant is based. As awareness of the behavioral capacities of the newborn infant has increased, there has been a concurrent effort to identify prenatal and postnatal factors that may influence behavioral development during the neonatal period and throughout the first years of life. Infants born into poverty are at greater risk of prenatal and postnatal insult, including preterm birth, low birthweight, and interuterine growth retardation (U.S. Department of Health and Human Services, 1993). Previous evidence indicates that these factors are significantly related to poor feeding behaviors, atypical patterns of caretaker-infant interactions, and poor developmental outcomes (Brake et al., 1988; Wide and Meyers, 1988). For Black women, rates of low birthweight and preterm birth are the highest in the country (U.S. Department of Health and Human Services, 1993). As a result, Black infants may be at much greater risk for poor developmental outcomes related to poor feeding and atypical caretaker-infant interactions. Maternal health habits during pregnancy, such as the use of alcohol, tobacco or illegal drugs, also significantly impact feeding behavior and development in infants (Jacobson et al., 1984). Use of these substances, which may be higher among Black women, increases risks for poor feeding and developmental outcome among Black infants. Higher rates of low-birthweight infants, preterm birth, and maternal use of alcohol, tobacco and/or illegal drugs during pregnancy among Black women are related to a wide range of factors. Individual factors, such as level of psychological functioning, physical well-being and use of prenatal care, are important to maternal health decisions. However, a range of ecological and structural factors, such as lack of education and housing, inadequate nutrition and financial support, and the stressors of poverty, are critical correlates of maternal and infant outcomes (Klerman, 1990). These factors may impact outcomes directly by limiting access to resources for a healthy pregnancy and indirectly by impacting maternal psychological functioning. It is important to identify factors that influence outcomes for Black women and their infants. In particular, it is important to examine relationships between prenatal insult and development in Black infants, as well as to determine the extent to which prenatal insult may influence patterns of interaction between Black caretakers and their infants. Therefore, the purpose of this article is twofold. First, the behavioral capacities of the newborn infant, particularly the development of early feeding behaviors, are reviewed. The importance of early infant feeding behaviors to the physical, emotional, and cognitive development of the infant and the role of early feeding interactions as the context for the development of caretaker-infant relationships are discussed. Secondly, prenatal and postnatal factors that may place Black infants at higher risk for poor feeding in the first year of life are identified. The potential impact of these factors on the development of Black infants, patterns of interaction between Black infants and their caretakers, and subsequent development in Black infants is assessed. The specific effects of prenatal exposure to cocaine on infant feeding and behavior are identified. …