Observation of feeding episode
At 6, 9 and 12 months postpartum, data were collected on mother-child
interaction during feeding using a structured observation guide to
generate a description of daily life of mothers caring for their
children in their naturalistic rural setting of Rwanda. Three lunchtime
meal observations per child were made. The observations were done when
the principal investigator and the research assistants visited mothers
to conduct in depth interviews.
The “Opportunistic observation form” developed by ProPAN (Process for
the Promotion of Child feeding) (PAHO, WHO, and UNICEF,2013) was used to
collect data on responsive feeding and the type of food offered.
Three child practices were assessed: child’s interest in food,
self-feeding attempts and food refusal during the meal. A child was
interested in food if he/she readily opened his/her mouth and moved head
towards the spoon or hands when food was offered and not interested if
he/she turned away from food every time he/she was offered food.
Self-feeding was defined as any bite a child attempted or feed
himself/herself without assistance. Mothers’ practices that were
assessed consisted of encouragement and strategies to overcome food
refusal if any. Encouragement was defined as verbally encouraging the
child to eat when he/she is eating well and any non-aversive praise
offered to the child by the mother, encouraging the child to eat more
using gestures, games, or demonstrating how to eat. Mother’s
encouragement of self-feeding was assessed by observing if the mother
verbally encouraged, allowed or supported the child to self-feed
him/herself or to hold a spoon or touch food with hand. Other aspects
observed included who fed the child, what the child was given to eat,
and where the feeding took place. In addition, any social interaction
practice, verbal or gestural interaction, that took place during feeding
and concerned non-food subjects was recorded. The observation was
conducted from the start till the end of the mealtime.