Strategies to promote responsive bottle‐feeding in WIC predict less frequent use of food to soothe and healthier weight status for infants with negative temperaments

Abstract

Summary Background Infants with greater temperamental negative affectivity are at higher risk for overfeeding and excess weight gain. Objective To examine whether strategies to promote responsive bottle‐feeding within WIC promoted healthier maternal feeding practices and infant weight status among infants with greater negative affectivity. Methods Secondary analysis of data from a matched‐pair cluster randomized trial. Policy, systems and environmental change (PSE) strategies to promote responsive bottle‐feeding were implemented at three WIC clinics; these clinics were compared with three matched control clinics. Linear mixed models tested whether infant negative affectivity interacted with PSE strategies to predict feeding and weight outcomes when infants were 4–6 months old. Results Significant interactions between infant negative affectivity and PSE strategies were noted. Among infants with high negative affectivity, mothers in PSE clinics reported less frequent use of food to soothe (p = 0.009) compared with mothers in control clinics. Among infants with moderate (p = 0.008) or high (p = 0.029) negative affectivity, infants in PSE clinics had healthier weight status compared with infants in control clinics. Conclusions Promotion of responsive bottle‐feeding is an effective way to support WIC mothers and reduce risk for overfeeding and excess weight gain, particularly for mothers of infants with greater negative affectivity.