Mental health articles

Infant–parent relationship influences on feeding Feeding behaviours are a reflection of the blending of a number of intricately
interrelated physical, maturational and interpersonal factors. The substantially
automatic responses of the newborn to root and suckle and to engage in handto-mouth activity begin a learning process that culminates in self-feeding. The
first year of life is a particularly sensitive period for the acquisition of mature
eating behaviours.

For most babies, feeding is a pleasurable and rewarding experience that enriches
the infant–parent relationship. Hunger is replaced by satisfaction, and the
process is accompanied by multisensory associations. These include taste, tactile, olfactory, visual and auditory stimuli, particularly linked to the parent and to the feeding situation. The experience is particularly intense for the breastfed baby,
with more direct exposure to relevant odours and taste, more opportunities for
mutual touching and regulation, and reinforcement of maternal feelings.
Successful feeding is dependent on the nurturing capacities of the parent and on the continuing process of learning about the baby’s individuality, while the baby
is repeatedly experiencing the integrating cycle of hunger, followed by its
resolution with feeding. It is the first collaborative activity, necessary for
survival and well-being, that the baby takes part in. As such, the feeding
relationship may contribute much to the templates for future social interaction
that are laid down during the baby’s earliest interpersonal encounters.
In addition, feeding difficulties might predispose to later eating disorders.
Marchi & Cohen (1990) demonstrated significant stability in the prevalence of
problem feeding behaviours over time. Maladaptive eating patterns first
reported by parents when their children were one to 10 years of age tended to
persist. Families were subsequently interviewed, when their children were nine to 18 years, and again at 11 to 21 years. Early eating-related family discord,
problems in the self-control of eating behaviour and digestive problems were
shown to be associated with subsequent eating disorders.
When feeding goes well, the baby’s cues of wanting to be fed, and of being
ready to end a feed, are respected so that the baby learns to regulate her own food intake (Winnicott, 1964). Parents achieve appropriate understanding of their baby’s signals through identification with the baby, knowledge ‘from a
deeper level and not necessarily that part of the mind which has words for
everything’ (Winnicott, 1967/1996, p. 41). More relevant than being instructed
in what to do is the parent’s experience of adapting to the baby, and most feeding
difficulties, in the absence of a significant medical cause, arise from the challenge
of negotiating this adaptation (Winnicott, 1967/1996). This process is facilitated
by a supportive social network.
As a baby matures and achieves increasing autonomy, the sensitive parent
allows for growing competence, and provides opportunities for new feeding
skills to be exercised. This includes weaning from breast or bottle, once cup
feeding is fully achieved, and broadening the social context of feeding when it
becomes a family mealtime. ‘Weaning is the first experience of permanent loss’,and how successfully the
transition is negotiated may influence the infant’s capacity to tolerate
subsequent losses in life. The transition to self-feeding allows the infant more
opportunities for autonomy, and for the exploration of a wider range of food
tastes and textures.