Le but de cette étude était de montrer que les troubles du comportement alimentaire (TCA) précoces sont associés avec le tempérament du nourrisson et avec les caractéristiques émotionnelles et alimentaires des parents. L’échantillon était composé de 58 dyades parent–nourrisson présentant un TCA, comparé à 60 témoins mangeurs sains. Ces dyades ont été observées au travers de l’enregistrement vidéo d’un repas de l’enfant et ont répondu à un panel de questionnaires relatifs au tempérament de l’enfant, à son développement psychoaffectif et comportemental, aux habitudes alimentaires du parent et à son état émotionnel durant la prise alimentaire de l’enfant. Les interactions durant le repas ont été évaluées avec la Feeding Scale de Chatoor. Des tests de Student et le test exact de Fisher ont été utilisés pour les variables quantitatives et qualitatives. Une approche par régression multiple a permis de vérifier la validité des résultats trouvés lors de l’analyse bivariée en ajustant les tests sur l’âge. Comparés aux témoins, les nourrissons présentaient des scores plus élevés en termes de caractéristiques symptomatiques et leurs parents des affects négatifs (21,5±8,1 vs 15,2±8,3, t=5,8 ; p=0) et d’avantage de difficultés alimentaires (14,5±5,8 vs 11,4±5,5, t=2,2, p=0,034). Ces dyades ont fait preuve d’un manque de réciprocité et d’échanges hautement conflictuels (Z-score moyen=4,7 [p=0]). Les résultats précisent donc en partie les relations établies dans la littérature internationale entre le tempérament du nourrisson atteint de TCA et les caractéristiques parentales dans un contexte de TCA précoce.

Interest in the study of early feeding disorders (FD) has steadily increased during recent decades. During this period, research described the importance of the transactional relationships and the complex interplay between caregiver and child over time. On the basis of the previous studies, our study tried to explore the associations between the characteristics of the parents and the temperamental characteristics of the infants with early FD.

A first aim of the present study was to show if parental perception of child temperament (including ability for arousal self-regulation) and parental characteristics (emotional and eating attitudes) are associated with early FD. A second aim was to identify emotional/behavioral difficulties in children with early FD by comparing children with a normal development and children with a diagnosed FD, and to investigate whether there are any correlations between parental emotional and feeding characteristics and a child's eating and emotional-behavioral development. A final aim was to explore if feeding conflict is bound to both infant ability for arousal self-regulatation and caregiver emotional status during meals.

Participants: 58 clinical dyads (children aged 1–36 months) and 60 in the control group participated in the study. The sample of 58 infants and young children and their parents was recruited in a pediatric hospital. They were compared to healthy children recruited in several nurseries. Procedure: all parent-child pairs in the clinical sample were observed in a 20-minute video-recording during a meal using the procedure of the Chatoor Feeding Scale. After the videotaping, parents completed a battery of self-report questionnaires assessing their child's and their own psychological symptom status. Measures: Child's malnutrition assessment was based on the Waterlow criteria. The Child Behavior Checklist (CBCL 1½–5) was used to assess a child's emotional/behavioral functioning. The Infant Behavior Questionnaire-Revised (IBQ-R), a widely used parent-report measure of infant temperament, was used to identify the structure of infant temperament. The Eating Attitude Test-40, a self-report symptom inventory, was used to identify concerns with eating and weight in the adult population. The Chatoor Feeding Scale was used to assess mother–child feeding interactions during a meal based on the analysis of the videotaped feeding session.

Analyses revealed that children with FD did not have a difficult temperament, especially no disability for arousal of self-regulatation, but their emotional-behavioral functioning is characterized by internalizing problems. Analyses of the EAT-40 showed that mothers of the children diagnosed with FD had significantly higher scores than mothers of the control sample; it means these mothers showed more dysfunctional eating attitudes. In addition, meals were characterized by negative effects in parents in the clinical group. When compared to the control sample, the feeding interactions between children with FD and their parents were characterized by low dyadic reciprocity, high maternal non-contingency, great interactional conflict and struggles with food. However, no significant correlation emerged either between the severity of malnutrition in infants or the conflict during feeding.

Our study confirms the relations established in previous research. Finally, future longitudinal studies are needed to further clarify and investigate others factors that may be involved in early feeding disorders.