A Randomized Pilot Study of Behavioral Treatment to Increase Calorie Intake in Toddlers With Cystic Fibrosis

Mealtime behaviors in families of infants and toddlers with cystic fibrosis

“…Previous research has suggested that parents of infants and toddlers with CF perceive more problems with their own strategies for managing mealtimes than parents of healthy children [5]. Parents of young children with CF likely need more effective mealtime management strategies and nutrition counseling that incorporates behavioral approaches to be successful in meeting the current CF nutritional guidelines [6,12,18,27].…”

“…Thus, early nutrition interventions for families of infants and toddlers with CF may need to include parent training to change the ways parents respond to typical child mealtime behaviors throughout the meal and address the tendency for more disruptive behaviors to occur during the second half of the meal. It is reasonable to assume that more optimal care might result from intervening with infants and toddlers with CF early to prevent or manage effectively mealtime behavior problems as the child develops, thereby making it more likely for young children with CF to consume their recommended calories [6,12,23,27].…”

“…In a prior treatment outcome study [24], we demonstrated that reducing the duration of meals led to an increase in the number of bites per minute. Therefore, as an intervention for families of young children with CF, it may be helpful to advise parents to limit the length of mealtimes and to teach parents behavior management strategies that effectively encourage eating behaviors (e.g., physical prompts) rather than risk inadvertently reinforcing noncompliance or dawdling [12,27].…”

“…In either scenario, intervention would be beneficial to assist parents in acquiring effective skills for dealing with typical childhood mealtime behaviors in order to change their sense of concern and maximize their children's energy intake. Two intervention studies with toddlers and preschool-age children indicate that behavioral intervention shows promise for changing these parent/child interactions and increasing calorie intake to meet the goals for this disease [12,27].…”

“…Understanding the specifics of parent and child behaviors during mealtimes for the 7 -35 month age group of children with CF will inform the development of nutritional and behavioral treatments called for in recent reports [1,5,6]. Empirical evaluation of promising biobehavioral interventions aimed at growth and nutrition early in life has become an important area for CF research and evidence-based care [5,12,27].…”