Table 1.
Summary of Starting Early Program Content Before the 10-Month-Old Assessment
| StEP sessions | Time | Content | |
|---|---|---|---|
| 1 | Individual | Third trimester prenatal visit | Discussed: |
| Introduction to Starting Early Program and RD/certified lactation counselor who will work with intervention subjects for next 3 years | |||
| Healthy infant feeding and benefits of breastfeeding | |||
| Assessment of feeding intentions and perceived barriers | |||
| Problem solving for perceived barriers | |||
| 2 | Individual | Postpartum hospital stay | Discussed: |
| Healthy infant feeding and benefits of breastfeeding | |||
| Assessment of feeding intentions and perceived barriers | |||
| Demonstrated and practiced: | |||
| Lactation support (skin-to-skin, latch assistance) | |||
| Healthy bottle feeding (infant led feeding) | |||
| Offered on-going support for lactation and other infant feeding issues | |||
| Scheduled pediatric visits and NPSG | |||
| 3 | NPSG-1 | Infant 1 month pediatric visit | Discussed: |
| Breastfeeding and healthy bottle feeding | |||
| Recognizing infant feeding cues | |||
| Nonfeeding related infant soothing techniques | |||
| Demonstrated and practiced: | |||
| Sharing positive and negative feeding experiences | |||
| Strategizing solutions to common feeding concerns | |||
| Recognizing cues with baby face photos | |||
| Pointing out cues in nutrition DVD (distributing DVD to take home) | |||
| Identifying their infant's hunger/fullness cues during observed feeding | |||
| Soothing without feeding (e.g., swaddling, swinging) | |||
| 4 | NPSG-2 | Infant 2-month pediatric visit | Discussed: |
| How much to feed | |||
| Recognizing infant feeding cues | |||
| Meaning of infant crying | |||
| Avoiding early introduction of complementary food or liquids | |||
| Importance of movement, activity and tummy time for infants | |||
| Demonstrated and practiced: | |||
| Identifying feeding cues (BINGO game) | |||
| Soothing without feeding (e.g., swaddling, swinging) | |||
| Tummy time together on blankets and floor mats | |||
| 5 | NPSG-3 | Infant 4-month pediatric visit | Discussed: |
| Breastfeeding and healthy bottle feeding | |||
| Signs of infant readiness to eat solids | |||
| Reasons to wait until age 6 months to introduce solids | |||
| Healthy first foods | |||
| Healthy sleep routines | |||
| Demonstration and practice: | |||
| Identifying developmental signs that indicate delaying introduction of solids until 6 months | |||
| Preparing commercial and homemade infant cereal | |||
| 6 | NPSG-4 | Infant 6-month pediatric visit | Discussed: |
| Introduction of complementary foods | |||
| Age-appropriate portion sizes | |||
| Examples of healthy meal and snack routines | |||
| Responsive feeding | |||
| Interacting and talking during meals | |||
| Avoiding media exposure during meals | |||
| Demonstrations and practice: | |||
| Preparing homemade baby food purees (banana and sweet potatoes) | |||
| Comparing taste of commercial and homemade baby foods | |||
| Eating family meal together in the group | |||
| Identifying active ways to play together | |||
| 7 | NPSG-5 | Infant 9-month pediatric visit | Discussed: |
| Feeding the older infant: self-feeding, healthy portion sizes, meal and snack patterns, family meals, water and human milk or formula as primary drink, and cup introduction | |||
| Parent's role in feeding: offering infants healthy foods and allowing the infant to decide how much to eat | |||
| Demonstrations and practice: | |||
| Eating family meal together in the group | |||
| Measuring out appropriate infant portion sizes | |||
| Identifying their infant's hunger and fullness cues during group meal | |||
| Practicing self-feeding in high chairs | |||
| Demonstration of sugar quantity in juice and fruit punch | |||