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Observing Responsive Feeding Behaviors in the Home: Parent/Caregiver Behavior

This observation tool serves as a resource for home visiting or other Head Start staff working with families in the home to help them observe effectively for parent and child responsive feeding behaviors in the home environment. Observations can be shared with parents to validate current practices and parent and child strengths. Learn how  to identify opportunities for future goals around responsive feeding and healthy mealtime practices.

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Environment

  • Ensures that feeding environment is pleasant with few distractions
  • Ensures that the child is seated comfortably, ideally facing others to allow for eye contact among family members
  • Avoids screen use during mealtimes

Behavior

  • Models healthy eating habits by making healthy choices
  • Has conversations about food and/or encourages the child verbally during mealtimes

Preparation

  • Ensures that food is healthy, tasty, and developmentally appropriate
  • Offers food on a predictable schedule

Reads and Responds to Child Cues

  • Encourages and observes the child’s signals of hunger and satiety (i.e., fullness)
  • Responds to the child’s feeding needs in a prompt, emotionally supportive, and developmentally appropriate manner
  • If the child refuses many foods, experiments with different food combinations, tastes, textures, and methods of encouragement
  • Does not pressure the child to eat or finish the food served to them
  • Avoids intrusive attempts at direct feeding (i.e., force-feeding, holding the child’s head, and threatening or shaking the child)
Age Range Parent/Caregiver Behavior Child Behavior
Birth to 6 months
  • Breastfeeds or bottle-feeds on demand
  • Observes/notices the child’s hunger and satiety cues
  • Responds to the child’s feeding cues appropriately by feeding or discontinuing feeding the baby
  • Prepares to feed when the baby signals hunger
  • Signals hunger and satiety through voice, facial expressions and actions
  • Uses hunger cues such as: Moves hands or puts things in mouth, displays rooting reflex, makes sucking noises or motions, clenches fist over chest and tummy
  • Uses fullness cues such as: Moves into intermittent pattern of sucking (i.e., stopping/starting), unlatches often while breastfeeding; pace of feeding slows down significantly; eyes become heavy, becomes drowsy or falls asleep; fidgets or gets distracted easily; closes mouth or turns away when breast or bottle is offered, and extends or relaxes fingers
6 to 12 months
  • Responds to the child’s feeding signals
  • Introduces new foods, with increased variety, texture, and tastes
  • Introduces a variety of fruits and vegetables, according to health care provider’s recommendations
  • Responds positively to the child’s attempts to self-feed (if this is a family goal)
  • Signals hunger and satiety through voice, facial expressions, and actions
  • Sits with good head control
  • Uses hunger cues such as: Leans toward food and opens mouth; gets excited when seeing food; focuses on and follows food with eyes
  • Uses fullness cues such as: Spits out or pushes food away, fidgets or gets distracted easily, closes mouth when food offered, turns head away from food, plays with food
  • Chews and swallows semi-solid foods
  • Self-feeds by hand (if this is a family goal)
1 to 3 years
  • Offers three to four healthy meal choices each day
  • Offers two to three healthy snacks each day
  • Offers food that can be safely picked up, chewed, and swallowed
  • Responds to the child’s signals of hunger and satiety
  • Respects the child’s satiety cues (e.g., when child signals “all done”)
  • Feeds child slowly and patiently
  • Responds positively to the child’s attempts to self-feed. For example: Assists the child with skills of eating while allowing child to pick up foods with their fingers and self-feed
  • Makes the child’s meals part of family meals as much as possible
  • Avoids practices such as the “Clean Plate Club” or bribing children to finish a healthy food in exchange for dessert
  • Anticipates mealtimes and has food ready before the child is over-hungry, tired, or crying
  • Self-feeds many different foods
  • Uses child-safe utensils
  • Uses words to signal feeding requests
  • May establish strong preferences for certain foods
  • May use mealtime as a setting within which to exercise autonomy around food choices, self-feeding, etc.

References:

Harbron, J., S. Booley, B. Najaar, C.E. Day. "Responsive Feeding: Establishing Healthy Eating Behaviour Early on in Life," South African Journal of Clinical Nutrition, 26(3), (2013): S141–S149.

"Starting Solid Foods." Healthy Children/American Academy of Pediatrics. (Jan. 16, 2018). Retrieved from https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Starting-Solid-Foods.aspx

"Is Your Baby Hungry or Full? Responsive Feeding Explained." Healthy Children/American Academy of Pediatrics." (Sept. 1, 2017). Retrieved from: https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Is-Your-Baby-Hungry-or-Full-Responsive-Feeding-Explained.aspx

"Responsive Feeding – Set Your Baby Up for Healthy Growth and Development." Institute for Healthy Childhood Weight/American Academy of Pediatrics. (Aug. 24, 2017). Retrieved from https://ihcw.aap.org/Pages/EFHALF_parents.aspx

McNally, J. et al. "Communicating Hunger and Satiation in the First 2 Years of Life: A Systematic Review." Maternal and Child Nutrition, 12(2), (2015): 205–228.

Robert Wood Johnson Foundation. Feeding Infants and Toddlers: Using the Latest Evidence in Child Care Settings. Princeton, NJ, May 2017. Retrieved from: https://healthyeatingresearch.org/wp-content/uploads/2017/05/her_ece_051817-FINAL.pdf

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