Preterm birth and feeding interactions in early childhood: the role of early parenting practices

Background Preterm birth is associated to feeding disorders in early childhood (Hvelplund et al., 2016). This association has been linked to early parent-infant relationship difficulties (Forcada- Guex et al., 2006). With few exceptions (e.g., Salvatori et al., 2015), however, feeding difficulties have been assessed through self-report measures, calling for more ecologically valid measures. Exploration of the link to early parenting practices has also only focused on the first 18 months, highlighting the need for longer-term investigations. Aims and Objectives Through observational measures, this study aimed to assess the effect of preterm birth on feeding interactions in early childhood, and its relation to early parenting practices. Method Mother-infant feeding interactions were assessed at 18, 24 and 30 months, using the Feeding Scale (Chatoor et al., 1997; Lucarelli et al., 2002), in 44 preterm infants (PI) and 25 full-term infants (FI). Parenting practices during play interactions were assessed at 18 months, using the Emotional Availability Scales (Biringen et al., 1998). Infant cognitive development, and maternal depression and anxiety were assessed, to control for their influence. Results Compared to FI, feeding interactions between mothers and PI were poorer at all timepoints, with greater conflict (p=0.003), and lower affective reciprocity (p=0.002). During play interactions at 18 months, mothers of PI evidenced greater intrusiveness (p=0.010) and lower sensitivity (p=0.017) than mother of FI. These early parenting differences mediated the long-term effect of prematurity on feeding interactions, explaining 53.44% and 46.49% of its effect on conflict (indirect effect: p=0.026) and reciprocity (indirect effect: p=0.037), respectively. Interpretation / Discussion Preterm birth was associated with feeding interaction disturbances that endured throughout the second and third year of life. This effect of prematurity was explained by poorer early parenting practices in the preterm group. Conclusions These findings highlight a potential long-term indirect effect of supporting early parenting