Feeding Development and Difficulties

Social and Emotional Development

  • Social puzzle piece - red

    • Feeding across all stages of feeding development is a relationship between mother (or carers) and baby that provides opportunities for interaction, socialising, forming attachments, regulating emotions, achieving satisfaction and developing trust.
    • Child and carer are equal partners in the feeding relationship.
    • Enjoyable feeding experiences further strengthen social interactions and emotional development.

    Exclusive breast or formula feeding

    • Early feeding success is dependent on the establishment of:  
      • Self regulatory processes of the baby.
      • Mother’s availability.
      • Baby’s capacity to emit a repertoire of cues to indicate needs.
      • Identification of cues and sensitive response by mother.
    • Baby gets ‘in sync’ with mother with respect to feeding and also with the self.
    Baby Parent

    During the first few days and months of life baby:

    • Achieves homeostasis - able to achieve a calm state and take an interest in the world.
      • Learns to identify and communicate needs such as hunger.
      • Becomes aware of others around them.
      • Uses non verbal communication to interact e.g. makes eye contact and responds socially to others.
      • Reacts to discomfort or pain and can signal this more clearly.
    • Begins to build relationships with others forming attachments especially with mother or primary carer.
      • Develops trust when needs are met.
      • Feeding becomes anticipated, pleasurable and social.
      • May pause during feeding to socialise rather than to indicate satiety.
    • Begins to engage in intentional two-way non verbal communications making sense of the interaction.
    • Facilitates achievement of homeostasis helping baby to self regulate and calm to enable feeding.
      • Responds to infant cues indicating hunger, satiety and other needs establishing cycles of sleeping, feeding and wakefulness.
    • Demand feeding helps baby to:
      • Regulate feeding in response to hunger and satiety.
      • Develop trust.
      • Develop a sense of autonomy
    • Feeding provides the opportunity to establish and build relationships:
      • ‘Falling in love’. 
      • Understanding baby’s temperament, behavioural style and preferences.

    First Foods

    • Enjoyment in relating and engaging with others parallels the introduction of first foods.
    Baby Parent
    • Expresses a range of emotions and trusts parents to meet needs.
    • Reassured by carer’s body language e.g. smile indicates ‘This must be okay’ or ‘I’m doing a good job’.
    • Anticipates touch or being lifted - turns head to people.
    • Interacts with people, especially primary cares, in back-and-forth reciprocal manner, sending and receiving nonverbal messages that make sense in the interaction.
    • Consolidates attachments.  May show preference for who feeds them.
    • Feeding becomes an opportunity for exploration and play.
    • Interprets and meets baby's needs with increasing confidence.
    • Presents food with confidence and reassurance.
    • Engages in reciprocal communications with baby.
    • Allows baby time to explore new foods at their own pace.

    Increasing variety

    • Mastering reciprocal communications supports progression in feeding development.
    • Increasing the variety of foods in the diet parallels desire for independence.
    • Enjoyment of the social interactions at mealtimes increases.
    Baby Parent
    • Expresses greater range of emotions that become easier to read e.g. happiness, sadness, fear, anger, frustration.
      • Demonstrates clearly what is wanted and not wanted including with food.
      • Begins to copy behaviours and emotions.
    • Desire for independence increases.
      • Negotiates who will do the feeding.
      • Allows parent to do some of the feeding while learning to self feed.
      • Dependency on parent for feeding gradually reduces.
    • Begins to behave and relate with organized, coherent patterns; puts together logical chains of behaviour.
      • Mealtimes become more predictable.
      • Begins to problem solve together with parent.
    • Enjoys social interactions at mealtimes.
    • Recognises and supports baby’s desire for independence.
      • Encourages and supports baby to practice self-feeding.
      • Recognises and provides help when required.
    • Ensures mealtimes continue to be interactive promoting reciprocal communications.
    • Provides a positive nurturing mealtime environment.

    Independent feeder

    • Learns to control emotional responses to foods and mealtimes.
    • Motivated to self feed and increase independence by a sense of achievement when new tasks are mastered.
    Child Parent
    • Recognises but may have difficulty in expressing emotions.
      • Tantrums involving food and mealtimes may occur.  Usually reduce over time as learns to regulate emotions, feels emotions are understood by others and develops more confidence in communicating their point of view.
    • Develops symbolic expression.
      • Becomes more abstract with play and can symbolise the feeding relationship e.g.  Feeding teddy, pretend tea party, or home corner play.
    • Asserts independence but requires limits with respect to length of mealtime and acceptable mealtime behaviours.
    • Shows pleasure when parents want to share their experience.
    • Enjoys trying to help.
      • Motivated to copy others - including eating the same food.
    • Encourages child to express emotions.
      • Models appropriate expression of emotions.
      • Provides opportunities for learning through play.
    • Supports progression to feeding independence but sets limits.
    • Has consistent expectations for mealtime behaviours but is not controlling.
    • Provides opportunities for problem solving by providing new experiences.
      • Provides new foods to explore. 
      • Different utensils for feeding.

    Further reading:

    Chatoor, I. (2009) Diagnosis and treatment of feeding disorders in infants, toddlers and young children. Washington, DC: ZERO TO THREE. Cullinane, D. and P. Novak, Parent's/Caregiver's Relationship and the Impact on Nutrition. ICAN: Infant, Child, & Adolescent Nutrition, 2013. 5(5): p. 311-314.

    Udall, J.N., Infant Feeding: Initiation, Problems, Approaches. Current problems in pediatric and adolescent health care, 2007. 37(10): p. 374-399.

    Ellyn Satter Institute