Associations between Infant Temperament, Sleep, Feeding, and Weight in Infancy and Early Childhood

• In Event: Infant sleep and the development of obesity: Direct and indirect associations in four longitudinal cohorts

Abstract

Infant temperament is characterized by individual differences in reactivity and regulation, which often influence parenting decisions related to sleep and feeding. These decisions can influence physical growth trajectories during infancy and early childhood. For example, higher levels of temperamental negativity may evoke obesogenic feeding practices, such as parental use of food to soothe (FTS) infant distress and feeding at night (Stifter et al., 2011). To explore the interconnections between temperament, sleep, and feeding, the present study will assess: 1) concurrent associations between maternal education, infant temperament, sleep, parent feeding practices, and infant weight status at 12 months, and 2) longitudinal associations between these predictors and child BMI z-scores at 4 years of age.

Child-parent dyads (n = 136) participated in lab visits as part of a longitudinal study when infants were 6 and 12 months of age. A subset of the sample (n = 112) participated in a follow-up visit when children were 4 years of age. At study entry, mothers reported their child’s birth weight and family demographic information. Before the 12-month visit, mothers reported: (1) child daytime and nighttime sleep durations, (2) child temperamental negativity using the Infant Behavior Questionnaire- Revised (Gartstein & Rothbart, 2003), and (3) feeding practices (i.e., breastfeeding duration, the infant’s current feeding mode, use of FTS infant distress via the Baby’s Basic Needs Questionnaire [Stifter et al., 2011], and feeding formula or other food during night wakings). At each study visit, the child’s length/height and weight were measured and used to calculate weight-for-length (12M) or body mass index (BMI; 4Y) z-scores according to the WHO/CDC growth standards, respectively. Mothers’ height and weight were also collected by trained research staff at the infant visits and used to calculate BMI.

Higher infant negativity was associated with greater use of FTS, r(130)= .32, p< .001, and inversely associated with infant sleep duration at 12 months of age, r(128)= -.27, p=.002 (Table 1). Additionally, higher maternal education was associated with lower maternal BMI, r(137)= -.26, p= .002, longer breastfeeding, r(134)= .27, p= .002, lower reported infant negativity, r(130)= -.21, p= .016, longer infant sleep durations, r(128)= .30, p< .001, and less feeding during night waking, r(128)= -.27, p= .002. Regression analyses (with covariates; r2= .23, F= 3.02, p= .01) demonstrated that lower infant negativity (β=-.33, SE=.22, p= .005), less sleep (β=-.26, SE=.00, p=.016), and feeding during night wakings (β=-.22, SE=.27, p=.035), were all associated with higher BMI z-scores at 4 years of age (Table 2).

The present study highlights how maternal education informs the use of several obesogenic parenting practices early in life, which were associated with later elevated BMI z-scores. The interrelationships between infant temperament, sleep, parent feeding practices, and child weight are complex, and likely reflect developmental cascades that are heavily contextually influenced. Future interventions designed to reduce childhood obesity risk could be well-informed to target not only feeding practices but also how parents perceive and react to infant negativity and night wakings.

Authors

• Kameron Moding, Purdue University, West Lafayette
  Presenting Author

• Elizabeth Irene Kielb, Purdue University, West Lafayette

• Amy Janis, Purdue University, West Lafayette

• AJ Schwichtenberg, Purdue University, West Lafayette