Intellectual and Developmental Status in Children With Hyperphenylalaninemia and PKU Who Were Screened in a National Program

Background: Hyperphenylalaninemia (HPA) and Phenylkeonuria (PKU) are metabolic errors caused by deficiency of phenylalanine hydroxylase enzyme, which results in increased level of phenylalanine. This increase is toxic to the growing brain. Objectives: The purpose of this study was to compare the intellectual and developmental status in HPA and PKU children with normal population in national screening program. Patients and Methods: In a historical cohort study, 41 PKU patients who had the inclusion criteria and 41 healthy children were evaluated. Wechsler preschool and primary scale of intelligence-3rd edition (WPPI-3) was used in order to assess the intellectual status of children 4 years and older and Ages and stages questionnaire (ASQ) was used to assess the developmental status of children 5 years and younger. Results: In intellectual test comparison, the two groups showed significant difference in Wechsler’s performance intelligence score and some performance subscales (P-value < 0.01). In comparison of developmental status, no significant difference was observed between the two groups (P-value > 0.05). Conclusions: Even with early diagnosis and treatment of PKU patients, these children show some deficiencies intellectually compared to normal children. This study emphasizes on necessity for screening intellectual and developmental status of PKU patients so that effective medical or educational measures can taken in case of deficiencies.

The Broken Mirror: Maternal Agency and Identity in Charles Dickens's Bleak House

This paper examined how Esther Summerson, Dickens’s ideal good mother, can be understood as a woman who has maternal agency and identity both as a character and as a narrator, and how she contrasts with other maternal characters in the novel, both major and minor. While more transgressive mothers, such as Lady Dedlock, Mrs. Jellyby and even Krook’s cat, are doomed to death, ineffectiveness and madness, Esther moves from a frozen, “unsexualized” state into a space of life and sexual possibility. In addition, Esther has agency and identity as a narrator since she shares the narration with a third-person male narrator. Esther becomes the one who speaks rather than the one who is spoken of, and her maternal, nurturing voice provides a balm for the often harsh, judgmental voice of the male narrator. As the narrator’s patriarchal voice dies away at the end, it is Esther’s maternal voice that survives.

Efeitos da inclinação da esteira na marcha de crianças com síndrome de down

Background: Down syndrome (DS) is a genetic alteration characterized by being a nonprogressive congenital encephalopathy. Children with DS have hypotonia and developmental delays that interfere in the movement`s acquisition for these children. Objective: Analyze the effects of treadmill inclination on angle and spatiotemporal gait characteristics of these individuals. Methodology: We studied 23 subjects of both sexes, with ages ranged between 05 and 11 years, they presented ability to walk on level 5 classified according to the Functional Ambulation Category (FAC). Initially held a subjective evaluation of balance through a questionnaire (Berg Balance Scale-BBS) then the kinematic gait analysis was realized on a treadmill first, without inclination and then, with inclination of 10%, using the motion system analysis Qualisys System. Data analysis was done using BioStat 5.0 attributing significance level of 5%. Normality of data was verified using D'Agostino test and later was applied paired t-test to compare data in two experimental conditions. Results: There was a statistically significant difference in the spatiotemporal variables: reduction in the cadence (from 108.92 ± 39.07 to 99.11 ± 27.51, p <0.04), increase in cycle time (from 1.24 ± 0.27 to 1.36 ± 0.34, p = 0.03 ) and increase in time to take stock (from 0.77 ± 0.15 to 0.82 ± 0.18, p <0.001). Angular variables that showed statistically significant increasing were: the hip in the initial contact (12.23 ± 4.63 to 18.49 ± 5.17, p <0.0001) and max. flexion in balance (12.96±4:32 to 19.50 ± 4.51, p <0.0001 ), knee in the initial contact (15.59 to ± 6.71 to 21.63 ± 6.48, p <0.0001), the ankle in the initial contact (-2.79 ± 9.8 to 2.25 ± 8.79, p <0.0001), max dorsiflexion in stance (4.41 ± 10.07 to 7.13 ± 11.58, p <0.0009), maximum plantar flexion in the pre-assessment of the ankle joint (increase of -6.33 ± 8.77 to -2.69 ± 8.62, p <0.0004).Conclusions: The inclination acts in a positive way for angular and spatiotemporal features gait of children with Down syndrome, demonstrating possible benefit of using this surface in the gait rehabilitation of children with Down Syndrome

Maternal support for autonomy : relationships with persistence for children with Down syndrome and typically developing children

Maternal behaviors and child mastery behaviors were examined in 25 children with Down syndrome and 43 typically developing children matched for mental age (24–36 months). During a shared problem-solving task, there were no group differences in maternal directiveness or support for autonomy, and mothers in the two groups used similar verbal strategies when helping their child. There were also no group differences in child mastery behaviors, measured as persistence with two optimally challenging tasks. However, the two groups differed in the relationships of maternal style with child persistence. Children with Down syndrome whose mothers were more supportive of their autonomy in the shared task displayed greater persistence when working independently on a challenging puzzle, while children of highly directive mothers displayed lower levels of persistence. For typically developing children, persistence was unrelated to maternal style, suggesting that mother behaviors may have different causes or consequences in the two groups.

Observational assessment and maternal reports of motivation in children and adolescents with Down Syndrome

Despite a lack of consistent empirical evidence, there has been an ongoing assumption that intellectual disability is associated with reduced levels of motivation. The participants in this study were 33 children with Down syndrome ages 10–15 years and 33 typically developing 3–8-year-old children. Motivation was measured through observational assessments of curiosity, preference for challenge, and persistence, as well as maternal reports. There were no significant group differences on motivation tasks, but mothers of children with Down syndrome rated their children significantly lower on motivation than did parents of typically developing children. There were some intriguing group differences in the pattern of correlations among observations and parent reports. The findings challenge long-held views that individuals with intellectual disability are invariably deficient in motivation.

Short- and long-term reproductive effects of prenatal and lactational growth restriction caused by maternal diabetes in male rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of himatanthus sucuuba in maternal reproductive outcome and fetal anomaly frequency in rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Iron status in early life and associations with developmental outcomes

Infants and young children are at particular risk of iron deficiency and its associated consequences for growth and development. The main objectives of this thesis were to quantify iron intakes, status and determinants of status in two year olds; explore determinants of neonatal iron stores; investigate associations between iron status at birth and two years with neurodevelopmental outcomes at two years and explore the influence of growth on iron status in early childhood, using data from the Cork BASELINE (Babies after SCOPE: Evaluating Longitudinal Impact using Neurological and Nutritional Endpoints) Birth Cohort Study (n=2137). Participants were followed prospectively with interviewer-led questionnaires and clinical assessments at day 2 and at 2, 6, 12 and 24 months. At two years, there was a low prevalence of iron deficiency and iron deficiency anaemia in this cohort, representing the largest study of iron status in toddlers in Europe, to date. The increased consumption of iron-fortified products and compliance with recommendations to limit unmodified cows’ milk intakes in toddlers has contributed to the observed improvements in status. Low serum ferritin concentrations at birth, which reflect neonatal iron stores, were shown to track through to two years of age; delivery by Caesarean section, being born small-for-gestational age and maternal obesity and smoking in pregnancy were all associated with significantly lower neonatal iron stores. Despite a low prevalence of iron deficiency in this cohort, both a mean corpuscular volume <74fl and ferritin concentrations <20μg/l were associated with lower neurodevelopmental outcomes at two years. An inverse association between growth in the second year of life and iron status at two years was also observed. This thesis has presented data from one of the largest, extensively-characterised cohorts of young children, to date, to explore iron and its associations with growth and development.

Maternal history of early adversity and child emotional development : investigating intervening factors

L’objectif de cette thèse était de contribuer à l’avancement des connaissances quant aux circonstances permettant une transmission intergénérationnelle du risque émanant de l’adversité maternelle et aux mécanismes sous-tendant cette transmission, dans quatre articles empiriques. Le premier visait à explorer la relation entre un historique d’adversité maternelle, la sécurité d’attachement mère-enfant et le tempérament de l’enfant. Les mères ont complété une entrevue semi-structurée portant sur leurs représentations d’attachement avec leurs parents, à 6 mois, et ont évalué le tempérament de leur enfant à 2 ans. La sécurité d’attachement fut également évaluée à 2 ans. Les résultats ont démontré que les enfants dont les mères rapportaient des niveaux supérieurs d’adversité présentaient de moins bons niveaux d’activité comportementale, uniquement lorsqu’ils avaient un attachement sécurisant avec leur mère. Ces résultats suggèrent une transmission intergénérationnelle des effets d’un historique d’adversité maternelle sur le tempérament des enfants. Le deuxième article visait à investiguer si le transporteur de sérotonine (5-HTTLPR) module la transmission de risque intergénérationnelle de l’adversité maternelle sur le tempérament des enfants. L’historique d’adversité maternelle fut évalué en combinant deux mesures auto-rapportées. Les mères ont également évalué le tempérament de leur enfant à 18 et à 36 mois. Le génotype des enfants fut extrait à 36 mois. Les résultats ont révélé un effet d’interaction entre l’adversité maternelle et le génotype de l’enfant sur le tempérament, suggérant une transmission intergénérationnelle des effets de l’adversité maternelle sur le fonctionnement émotionnel des enfants. Le troisième article visait à explorer la relation entre les difficultés d’adaptation psychosociale des mères, la sensibilité maternelle et les symptômes intériorisés de leurs enfants. Les mères ont complété plusieurs questionnaires desquels un score composite de difficultés d’adaptation psychosociale fut extrait. La sensibilité maternelle fut observée à 12 mois. Les symptômes intériorisés des enfants furent évalués par les deux parents à 2 et à 3 ans. Les résultats ont démontré qu’une augmentation des difficultés maternelles d’adaptation psychosociale étaient associée à davantage de symptômes intériorisés chez les enfants, mais seulement chez ceux dont les mères étaient moins sensibles. Ces résultats ont été observés par les mères à 2 ans et par les deux parents à 3 ans. Ces résultats suggèrent que les enfants peuvent être différemment affectés par l’adaptation émotionnelle de leur mère tout en mettant l’emphase sur le rôle protecteur de la sensibilité maternelle. Le quatrième article visait à investiguer les rôles médiateurs de la dépression et de la sensibilité maternelle dans la relation entre un historique d’adversité maternelle et le tempérament de l’enfant. L’historique d’adversité maternelle fut évalué en combinant deux mesures auto-rapportées. Les mères ont également rapporté leurs symptômes dépressifs à 6 mois. La sensibilité maternelle fut évaluée de façon concomitante. Les mères ont évalué le tempérament de leur enfant à 36 mois. Les résultats ont révélé une transmission intergénérationnelle des effets d’un historique d’adversité maternelle à la génération suivante suivant une médiation séquentielle passant d’abord par la dépression maternelle et ensuite par la sensibilité maternelle. Finalement, les résultats des quatre articles ont été intégrés dans la conclusion générale.

Maternal history of early adversity and child emotional development : investigating intervening factors

L’objectif de cette thèse était de contribuer à l’avancement des connaissances quant aux circonstances permettant une transmission intergénérationnelle du risque émanant de l’adversité maternelle et aux mécanismes sous-tendant cette transmission, dans quatre articles empiriques. Le premier visait à explorer la relation entre un historique d’adversité maternelle, la sécurité d’attachement mère-enfant et le tempérament de l’enfant. Les mères ont complété une entrevue semi-structurée portant sur leurs représentations d’attachement avec leurs parents, à 6 mois, et ont évalué le tempérament de leur enfant à 2 ans. La sécurité d’attachement fut également évaluée à 2 ans. Les résultats ont démontré que les enfants dont les mères rapportaient des niveaux supérieurs d’adversité présentaient de moins bons niveaux d’activité comportementale, uniquement lorsqu’ils avaient un attachement sécurisant avec leur mère. Ces résultats suggèrent une transmission intergénérationnelle des effets d’un historique d’adversité maternelle sur le tempérament des enfants. Le deuxième article visait à investiguer si le transporteur de sérotonine (5-HTTLPR) module la transmission de risque intergénérationnelle de l’adversité maternelle sur le tempérament des enfants. L’historique d’adversité maternelle fut évalué en combinant deux mesures auto-rapportées. Les mères ont également évalué le tempérament de leur enfant à 18 et à 36 mois. Le génotype des enfants fut extrait à 36 mois. Les résultats ont révélé un effet d’interaction entre l’adversité maternelle et le génotype de l’enfant sur le tempérament, suggérant une transmission intergénérationnelle des effets de l’adversité maternelle sur le fonctionnement émotionnel des enfants. Le troisième article visait à explorer la relation entre les difficultés d’adaptation psychosociale des mères, la sensibilité maternelle et les symptômes intériorisés de leurs enfants. Les mères ont complété plusieurs questionnaires desquels un score composite de difficultés d’adaptation psychosociale fut extrait. La sensibilité maternelle fut observée à 12 mois. Les symptômes intériorisés des enfants furent évalués par les deux parents à 2 et à 3 ans. Les résultats ont démontré qu’une augmentation des difficultés maternelles d’adaptation psychosociale étaient associée à davantage de symptômes intériorisés chez les enfants, mais seulement chez ceux dont les mères étaient moins sensibles. Ces résultats ont été observés par les mères à 2 ans et par les deux parents à 3 ans. Ces résultats suggèrent que les enfants peuvent être différemment affectés par l’adaptation émotionnelle de leur mère tout en mettant l’emphase sur le rôle protecteur de la sensibilité maternelle. Le quatrième article visait à investiguer les rôles médiateurs de la dépression et de la sensibilité maternelle dans la relation entre un historique d’adversité maternelle et le tempérament de l’enfant. L’historique d’adversité maternelle fut évalué en combinant deux mesures auto-rapportées. Les mères ont également rapporté leurs symptômes dépressifs à 6 mois. La sensibilité maternelle fut évaluée de façon concomitante. Les mères ont évalué le tempérament de leur enfant à 36 mois. Les résultats ont révélé une transmission intergénérationnelle des effets d’un historique d’adversité maternelle à la génération suivante suivant une médiation séquentielle passant d’abord par la dépression maternelle et ensuite par la sensibilité maternelle. Finalement, les résultats des quatre articles ont été intégrés dans la conclusion générale.

Cortisol Reactivity and Observed Parenting among Mothers of Children with and without ADHD

Parenting is a robust predictor of developmental outcomes among children with ADHD. Early parenting predicts the persistence and course of ADHD and comorbid problems above and beyond risk associated with shared genetic effects. Yet, on average, mothers of children with ADHD are less positive and more negative in their parent-child interactions compared to mothers of non-disordered children. Little is known about psychobiological markers which may be associated with individual variations in maternal parenting in families of children with ADHD. Neurobiological models of parenting suggest that maternal cortisol levels following a stressor may be positively associated with hostile and intrusive parenting; however, to date no studies have examined maternal cortisol reactivity and parenting in school-age, or clinical samples of, children. Mothers’ regulation of physiological stress responses may be particularly important for families of children with ADHD, as parenting a child with chronically challenging behaviors represents a persistent environmental stressor. The current study sought to extend the existing literature by providing an empirical examination of the relationship between maternal cortisol reactivity following two laboratory stressors and parenting among mothers of children with and without ADHD. It was hypothesized that child ADHD group would moderate the relationship between cortisol reactivity and self-reported and observed parenting. Greater total cortisol output and greater increase in cortisol during the TSST were associated with decreased positive parenting and increased negative and directive parenting, with the exception of parental involvement, which was associated with increased cortisol output during the TSST. Conversely, cortisol output during the PCI was associated with increased positive parenting, increased parental involvement, and decreased negative parenting. In contrast to the TSST, a greater decrease in cortisol during the PCI indicated more positive parenting and parental involvement. These associations were specific to mothers of children with ADHD, with the exception of maternal directiveness, which was specific to comparison mothers. Findings add to our understanding of physiological processes associated with maternal parenting and contribute to an integrative biological, psychological, and cognitive process model of parenting in families of children with ADHD.

Medical Provider Guide for Developmental Surveillance and Screening, July 2010

All children receive surveillance at every well-child visit, as recommended by the American Academy of Pediatrics (AAP), to recognize those who may be at risk for developmental delays. This includes assessing caregiver stress and depression and social-emotional development.

The development and validation of Australian indices of child development - Part II : validity support

The two outcome indices described in a companion paper (Sanson et al., Child Indicators Research, 2009) were developed using data from the Longitudinal Study of Australian Children (LSAC). These indices, one for infants and the other for 4 year to 5 year old children, were designed to fill the need for parsimonious measures of children’s developmental status to be used in analyses by a broad range of data users and to guide government policy and interventions to support young children’s optimal development. This paper presents evidence from Wave 1data from LSAC to support the validity of these indices and their three domain scores of Physical, Social/Emotional, and Learning. Relationships between the indices and child, maternal, family, and neighborhood factors which are known to relate concurrently to child outcomes were examined. Meaningful associations were found with the selected variables, thereby demonstrating the usefulness of the outcome indices as tools for understanding children’s development in their family and socio-cultural contexts. It is concluded that the outcome indices are valuable tools for increasing understanding of influences on children’s development, and for guiding policy and practice to optimize children’s life chances.

The effect of prolonged reading on visual functions and reading performance in students with low vision

This study is the first to investigate the effect of prolonged reading on reading performance and visual functions in students with low vision. The study focuses on one of the most common modes of achieving adequate magnification for reading by students with low vision, their close reading distance (proximal or relative distance magnification). Close reading distances impose high demands on near visual functions, such as accommodation and convergence. Previous research on accommodation in children with low vision shows that their accommodative responses are reduced compared to normal vision. In addition, there is an increased lag of accommodation for higher stimulus levels as may occur at close reading distance. Reduced accommodative responses in low vision and higher lag of accommodation at close reading distances together could impact on reading performance of students with low vision especially during prolonged reading tasks. The presence of convergence anomalies could further affect reading performance. Therefore, the aims of the present study were 1) To investigate the effect of prolonged reading on reading performance in students with low vision 2) To investigate the effect of prolonged reading on visual functions in students with low vision. This study was conducted as cross-sectional research on 42 students with low vision and a comparison group of 20 students with normal vision, aged 7 to 20 years. The students with low vision had vision impairments arising from a range of causes and represented a typical group of students with low vision, with no significant developmental delays, attending school in Brisbane, Australia. All participants underwent a battery of clinical tests before and after a prolonged reading task. An initial reading-specific history and pre-task measurements that included Bailey-Lovie distance and near visual acuities, Pelli-Robson contrast sensitivity, ocular deviations, sensory fusion, ocular motility, near point of accommodation (pull-away method), accuracy of accommodation (Monocular Estimation Method (MEM)) retinoscopy and Near Point of Convergence (NPC) (push-up method) were recorded for all participants. Reading performance measures were Maximum Oral Reading Rates (MORR), Near Text Visual Acuity (NTVA) and acuity reserves using Bailey-Lovie text charts. Symptoms of visual fatigue were assessed using the Convergence Insufficiency Symptom Survey (CISS) for all participants. Pre-task measurements of reading performance and accuracy of accommodation and NPC were compared with post-task measurements, to test for any effects of prolonged reading. The prolonged reading task involved reading a storybook silently for at least 30 minutes. The task was controlled for print size, contrast, difficulty level and content of the reading material. Silent Reading Rate (SRR) was recorded every 2 minutes during prolonged reading. Symptom scores and visual fatigue scores were also obtained for all participants. A visual fatigue analogue scale (VAS) was used to assess visual fatigue during the task, once at the beginning, once at the middle and once at the end of the task. In addition to the subjective assessments of visual fatigue, tonic accommodation was monitored using a photorefractor (PlusoptiX CR03™) every 6 minutes during the task, as an objective assessment of visual fatigue. Reading measures were done at the habitual reading distance of students with low vision and at 25 cms for students with normal vision. The initial history showed that the students with low vision read for significantly shorter periods at home compared to the students with normal vision. The working distances of participants with low vision ranged from 3-25 cms and half of them were not using any optical devices for magnification. Nearly half of the participants with low vision were able to resolve 8-point print (1M) at 25 cms. Half of the participants in the low vision group had ocular deviations and suppression at near. Reading rates were significantly reduced in students with low vision compared to those of students with normal vision. In addition, there were a significantly larger number of participants in the low vision group who could not sustain the 30-minute task compared to the normal vision group. However, there were no significant changes in reading rates during or following prolonged reading in either the low vision or normal vision groups. Individual changes in reading rates were independent of their baseline reading rates, indicating that the changes in reading rates during prolonged reading cannot be predicted from a typical clinical assessment of reading using brief reading tasks. Contrary to previous reports the silent reading rates of the students with low vision were significantly lower than their oral reading rates, although oral and silent reading was assessed using different methods. Although the visual acuity, contrast sensitivity, near point of convergence and accuracy of accommodation were significantly poorer for the low vision group compared to those of the normal vision group, there were no significant changes in any of these visual functions following prolonged reading in either group. Interestingly, a few students with low vision (n =10) were found to be reading at a distance closer than their near point of accommodation. This suggests a decreased sensitivity to blur. Further evaluation revealed that the equivalent intrinsic refractive errors (an estimate of the spherical dioptirc defocus which would be expected to yield a patient’s visual acuity in normal subjects) were significantly larger for the low vision group compared to those of the normal vision group. As expected, accommodative responses were significantly reduced for the low vision group compared to the expected norms, which is consistent with their close reading distances, reduced visual acuity and contrast sensitivity. For those in the low vision group who had an accommodative error exceeding their equivalent intrinsic refractive errors, a significant decrease in MORR was found following prolonged reading. The silent reading rates however were not significantly affected by accommodative errors in the present study. Suppression also had a significant impact on the changes in reading rates during prolonged reading. The participants who did not have suppression at near showed significant decreases in silent reading rates during and following prolonged reading. This impact of binocular vision at near on prolonged reading was possibly due to the high demands on convergence. The significant predictors of MORR in the low vision group were age, NTVA, reading interest and reading comprehension, accounting for 61.7% of the variances in MORR. SRR was not significantly influenced by any factors, except for the duration of the reading task sustained; participants with higher reading rates were able to sustain a longer reading duration. In students with normal vision, age was the only predictor of MORR. Participants with low vision also reported significantly greater visual fatigue compared to the normal vision group. Measures of tonic accommodation however were little influenced by visual fatigue in the present study. Visual fatigue analogue scores were found to be significantly associated with reading rates in students with low vision and normal vision. However, the patterns of association between visual fatigue and reading rates were different for SRR and MORR. The participants with low vision with higher symptom scores had lower SRRs and participants with higher visual fatigue had lower MORRs. As hypothesized, visual functions such as accuracy of accommodation and convergence did have an impact on prolonged reading in students with low vision, for students whose accommodative errors were greater than their equivalent intrinsic refractive errors, and for those who did not suppress one eye. Those students with low vision who have accommodative errors higher than their equivalent intrinsic refractive errors might significantly benefit from reading glasses. Similarly, considering prisms or occlusion for those without suppression might reduce the convergence demands in these students while using their close reading distances. The impact of these prescriptions on reading rates, reading interest and visual fatigue is an area of promising future research. Most importantly, it is evident from the present study that a combination of factors such as accommodative errors, near point of convergence and suppression should be considered when prescribing reading devices for students with low vision. Considering these factors would also assist rehabilitation specialists in identifying those students who are likely to experience difficulty in prolonged reading, which is otherwise not reflected during typical clinical reading assessments.

Parenting behaviours and maternal infant-feeding practices in first-time Australian mothers

Introduction: There is emerging evidence that parenting style and early feeding practices are associated with child intake, eating behaviours and weight status. The aim of this cross sectional study was to examine the relationships between general maternal parenting behaviour and feeding practices and beliefs. Methods: Participants were 421 first-time mothers of 9-22 week old healthy term infants (49% male, mean±sd age 19±4 weeks) enrolled in the NOURISH trial. At baseline mothers self-reported their parenting behaviours (self-efficacy, warmth, irritability) and infant-feeding beliefs using questions from the Longitudinal Study of Australian Children and the Infant Feeding Questionnaire (Baughcum, 2001), respectively. Multivariable regression analyses were used with feeding practices (four factors) as the dependent variables, Independent variables were maternal BMI, weight concern, age, education level perception of infant weight status, feeding mode (breast vs formula) and infant gender, age and weight gain z-score. Results: Parenting behaviours partly were associated with feeding beliefs (adjusted R2 =0.21-0.30). Higher maternal parenting self-efficacy was inversely associated with concerns that the baby would become underweight (p=0.006); become overweight (p<0.001); and lack of awareness of infant hunger/satiety cues (p<0.001). Higher maternal irritability was positively associated with lack of awareness of cues (p<0.05). Maternal warmth was not associated with any feeding beliefs. Infant weight- gain (from birth) z-score and age, maternal BMI and education level and mothers’ perception of infant weight status and feeding mode were covariates. Conclusions: These findings suggest strategies to improve early feeding practices need to be address broader parenting approaches, particularly self-efficacy and irritability.