Mothers' Eating Disorder History and Mother and Infant Attention to Food during Infant Meal Times: A Candidate for Intergenerational Transmission of Eating Disorder Behaviours

Fay Huntley^1,2*Rebecca Pearson³Ilaria Costantini^4,5Marc H. Bornstein^6,7Amy Campbell⁴Miguel Cordero⁸Nicky Wright^3*

• ¹University of Edinburgh, Edinburgh, United Kingdom
• ²The University of Edinburgh, Edinburgh, United Kingdom
• ³Manchester Metropolitan University, Manchester, United Kingdom
• ⁴University of Bristol, Bristol, United Kingdom
• ⁵University College London, London, United Kingdom
• ⁶National Institute of Child Health and Human Development, Rockville, United States
• ⁷Institute for Fiscal Studies, London, United Kingdom
• ⁸Universidad del Desarrollo Facultad de Medicina, Santiago, Chile

Abstract Introduction: There is evidence to suggest that individuals with eating disorders (ED) show differences in attention to food compared to those without eating disorders. Children of mothers with eating disorders are at an elevated risk of developing an eating disorder. One potential intergenerational pathway may be that parents, and then infants, pay more attention to food in interactions, which in turn mediates transmission of eating-disordered behaviour. No study has investigated whether mothers' ED behaviour history is associated with maternal and infant attention to food during infant feeding interactions. Methods: Mothers and 7-month-old infants from the Avon Longitudinal Study of Parents and Children Generation-2 (ALSPAC-G2) provided video footage of mother-infant feeding interactions filmed at home using head-cameras. Feeding interactions were coded for mothers' and infants' visual attention using a micro-behavioural observational coding system. Outcomes were mothers' and infants' proportion duration spent looking at food. Mothers' ED behaviour history was assessed at age 25 years using the Youth Risk Behaviour Surveillance System questionnaire, from which a binary DSM-5 disordered eating variable was generated. Linear regression testing associations between mothers' ED behaviour history and mother and infant attention to food were adjusted for infants' sex, age, and birth order, and mothers' age, education, and employment. Results: In 98 mother-infant dyads, mothers' ED behaviour history was associated with longer proportion duration of infants' looking at food during mealtimes (estimate = .59 [.19, .99], p=.004), corresponding to a 20% difference in time spent looking at food for infants of mothers with an ED behaviour history compared to those without. There was no association between ED behaviour history and mothers' attention to food. Conclusions Increased infant looking time to food during feeding may indicate a preoccupation with food. This preoccupation could be a reflection of ED behaviours being modelled to offspring by mothers or early behavioural markers of shared genetic risk for ED. Support for mother-infant dyads with an ED history could target guiding mothers' and infants' attention (via video feedback for example) to non-food related activities to minimise any impact on the mothers' relationship with the infant or the infants' relation with food.