Recognising and responding to infant appetite cues – implications for developing a “baby translator”

Caregivers vary in how well they recognise and respond to infant hunger, appetite, and satiety cues, which affects responsive feeding (RF). This thesis explored whether RF is “teachable” with an impact on infant health outcomes, and whether individuals’ ability to recognise infant appetitive cues is related to how well they “tune in” to their own internal appetite cues and affect (i.e., alexithymia, difficulty identifying and describing feelings). Four studies were conducted: one systematic review and three online studies.
Study 1 systematically reviewed interventions designed to support RF. Across studies with both digital and face-to-face interventions, parental self-reported RF improved, but intervention effects on children’s weight outcomes and eating patterns were inconsistent. These mixed findings suggest self-reported changes to RF behaviours did not necessarily impact child obesity risk.
Study 2 assessed accuracy in recognising infant appetitive cues in adults (N = 198) online using ten videoclips of infants at the start and end of meals. Recognition scores were high, but alexithymia score was negatively correlated with infant appetite recognition.
Study 3 examined whether caregivers’ (N = 445) “tuning in” to their own internal appetite and affect cues associated with infant-cue recognition during feeding. Caregivers who were attuned to their own internal cues scored high in recognising infant appetite. Those with alexithymia showed lower recognition and fewer positive mealtime emotions compared to caregivers without alexithymia. Caregivers’ ability to “tune in” to their own satiation cues inversely mediated the relationship between alexithymia and infant appetite recognition.
Study 4 included one-to-one semi-structured, video-elicited interviews with 14 parents from Study 3 who had high alexithymia scores. Reflexive thematic analysis revealed mealtime challenges, stress experienced by caregivers, and the effect of context on feeding practices.
Overall, findings showed that individual differences in tuning in to interoceptive cues were associated with parental ability to recognise and respond to infant appetitive cues. Tailored support for caregivers, especially those with alexithymia, may enhance parental sensitivity to their own and to their infants’ appetite and affect cues, with the potential to improve RF and positive mealtime experiences.