Development of the Baby Behaviors when Satiated (BABES) behavioral coding scheme

Current infant feeding recommendations promote responsive feeding, wherein caregivers respond to infants' cues to determine feeding pace and duration, to support infant self-regulation and healthy weight outcomes. A central tenet of responsive feeding is that infants will effectively signal hunger, receptiveness to feeding, needs to disengage from feeding, and satiation, yet there is a lack of research available to support this assumption. Rather, previous research illustrates substantial variability exists for the extent to which infants exhibit behavioral cues during feeding and that many mothers feel their infants do not clearly communicate satiation, suggesting certain caregivers need tailored support to understand their infants' needs during feeding interactions. As a first step toward addressing this research gap, we developed the Baby Behaviors when Satiated (BABES) coding scheme, a comprehensive tool that assesses infants' disengagement/satiation behaviors and mothers' responses to infant behaviors and feeding practices during mother-infant feeding interactions. The BABES was applied to 876 videos of bottle-feeding interactions from a prospective, longitudinal study of dyads observed when infants were 1, 2, 4, 6, 9, and 12 months old. Coders achieved moderate to strong inter-rater reliability. Descriptive analyses illustrated that the percentages of infants and mothers exhibiting different behaviors at each age were consistent with developmental trends noted in previous research. Application of this tool within future research holds the potential to create rich datasets allowing for description of intra- and inter-individual variability in infant and mother behaviors and how infants' and mothers' behaviors co-develop across the first year.