Mother- Child interaction during complementary feeding: Responsive feeding practices
During the observation at 6 months, the meal served to the child consisted mainly of cereal-based gruel, thin porridge, commonly made from a mixture of two or more flour such as maize, sorghum, soybeans. The consumption of animal-source foods, such as cow’s milk was limited. At 9 and 12 months, the varieties of foods offered to children ranged from the aforementioned cereals-based porridge to food from grains, roots and tubers groups (such as potatoes, plantains), legumes (mainly dried beans) and green leafy vegetables (amaranth).
The majority of mothers at all 3 time points (6, 9 and 12 months) reported to verbally encourage their children to eat, most commonly by making positive comments about food. However, at 6 months, some mothers pointed out that they don’t see the importance of verbally interacting with such a young child during feeding. Those women highlighted that they did not understand why they would attempt to converse with a child who is still too young to talk during feeding.
At 9 and 12 months, many of the mothers verbally interacted. They described how their children enjoy dialogue (being talked to) and how their children eat a great amount of food if they are talked to during feeding. For instance, 2 mothers said:
“I verbally encouraged him to eat by telling him that the food is very delicous which made him so happy that he ate the food with more interest.”   (W-01, month9)
Whenever I feed my kid I talk to him otherwise he doesn’t eat. He looks aside in the opposite direction of the food even if he would still want more food.” (W-23, month 12)
Furthermore, at 9 and 12 months, some mothers explained that verbally encouraging the child during feeding promotes language development, on top of stimulating the child to eat more. For example, one mother said:
“What I have observed is that when Italk to the child while eating, this motivates the child to eat more and boosts his capacity to speak.” (W-27, month 9)
Other mothers reported to motivate the child to eat more by demonstrating the child how to eat while others reported to engage in social interactions unrelated to food during feeding episode.Those non-food related social interactions consisted mainly of drawing out a child’s smile through copying and responding to the child’s sounds and making funny sounds to get their child to smile whereby the child responded by repetitive sounds (at 6 months). Mothers explained that drawing out a child’s smile was used to make the child feel loved by the mother and that it promotes a bond between the mother and the child. Other mothers, at 9 and 12 months, reported talking to their children by calling the child’s name or naming things. Some mothers explained that talking softly to the child was used as a way to provide social interaction while others expressed talking to the child to assist the child with language development.
“During feeding, I smile at him and see that the child is happy too”. (W-13, 6 months)
“When I hold my child, I sometimes make funny sounds to get the child to smile, and see that the child feels loved”. (W-10, 6 months)
“There is a time when he says anything and I respond by copying his sounds. By doing that, I realize that I stimulate the child’s language development”. (W-8,12 months)
“When he says anything, and I respond by copying the sounds, I see that the child is happy with that”. (W-27, 9 month)
The observation of feeding episodes showed that all infants were fed by their mothers and were given food from their own plates. Most children were held by mothers, seated on mothers’ laps. Most children accepted food when it was offered. At 6 months, most mothers’ feeding practices consisted mainly of putting food into the child’s month without any encouraging strategy or social interaction while few mothers were observed demonstrating the child how to eat. At9 and 12 months, close to a half of mothers were observed verbally encouraging their children to eat. In case of food refusals during feeding, most participants reported to encourage their children to eat more. Observations, however, revealed that the majority of mothers did not try any solution in case of food refusal but instead stopped feeding at all 3 points in times. A few mothers were observed using threatening verbalization (giving direct order) for more mouthful acceptance. For example, during the observation at 9 months, one mother said “I will beat you if you don’t eat this food. Eat” . Another mother was observed to physically force the child to eat more by holding the child’s hands down to force food into his mouth and commanding the child to eat.
At 6 months, most mothers reported to feed their infants and not allowing them to feed themselves. During the observation, at 6 and 9 months, all mothers fed their infants the entire time of feeding episode as they reported to believe the children are still too young to feed themselves. At 12 months, almost a half of the mothers provided their children the opportunity to feed themselves small finger foods at some time during feeding. Those mothers who let their children self-feed reported to recognize a child centered focus related to his/ her development, learning and autonomy, as 2 mothers stated:
“I used to assist him in eating for the entire time of the feeding episode but later I decided to let him feed himself under my supervision as part of his learning process. For instance, I wash his hands and put the food in a small plate. Then the child starts eating himself .” (W-17 month 12)
“I also assume that time will happen when I will not be nearby. Yet the child will have to absolutely eat. Consequently, I sometimes let him self-feed under my supervision as the child needs to know how to feed himself as he grows older .” (W-12, month 12)