Assessment of Feeding Interactions

Preterm infants and their families are at risk of problems in feeding interactions due to long periods of hospitalization and other factors. The feeding observation should include an assessment of how the caregiver and infant work together as a team during feeding. One systematic method for observing infant/caregiver interactions during feeding has been developed by Barnard et al. In the assessment tool devised by this group Caregiver and Infant Responsibilities during feeding are described as follows:

Caregiver Responsibilities:

  • Recognize and respond to the infant’s cues and respond in a contingent manner
  • Sooth or quiet a distressed infant
  • Demonstrate warmth and affection toward infant and communicate a positive feeling tone
  • Foster cognitive growth through touch, movement, and talking
  • Delay stimulating or responding until the infant signals readiness

Infant/Child Responsibilities

  • Send clear cues to the caregiver, including:
  1. Display of some tension at beginning of feeding and decrease in tension once feeding has begun
  2. Have periods of alertness during the feeding
  3. Older infants cue the caregiver for interaction through vocalization and smiles
  4. Cue the caregiver of need for a break or rest.
  • Respond to the caregiver’s attempts to communicate and interact
  • Stop crying when the caregiver attempts to sooth
  • Look in the direction of the caregiver’s face then the caregiver talks
  • Mold into the contours of the caregiver’s body
  • Suck and make feeding sounds following feeding attempts by the caregiver
  • Older infants vocalize or smile after the caregiver’s vocalization or smile


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