Origins of food reinforcement in infants 1 – 5

Background: Rapid weight gain in infancy is associated with a higher risk of obesity in children and adults. A high relative reinforcing value of food is cross-sectionally related to obesity; lean children find nonfood alternatives more reinforcing than do overweight/obese children. However, to our knowledge, there is no research on how and when food reinforcement develops. Objective: This study was designed to assess whether the reinforcing value of food and nonfood alternatives could be tested in 9to 18-mo-old infants and whether the reinforcing value of food and nonfood alternatives is differentially related to infant weight status. Design: Reinforcing values were assessed by using absolute progressive ratio schedules of reinforcement, with presentation of food and nonfood alternatives counterbalanced in 2 separate studies. Two nonfood reinforcers [Baby Einstein–Baby MacDonald shows (study 1, n = 27) or bubbles (study 2, n = 30)] were tested against the baby’s favorite food. Food reinforcing ratio (FRR) was quantified by measuring the reinforcing value of food (Food Pmax) in proportion to the total reinforcing value of food and a nonfood alternative (DVD Pmax or BUB Pmax). Results: Greater weight-for-length z score was associated with a greater FRR of a favorite food in study 1 (FRR-DVD) (r = 0.60, P , 0.001) and FRR of a favorite food in study 2 (FRRBUB) (r = 0.49, P = 0.006), primarily because of the strong association between greater weight-for-length z score and lower DVD Pmax (r = 20.71, P , 0.0001) and BUB Pmax (r = 20.53, P = 0.003). Infant monthly weight gain was positively associated with FRR-DVD (r = 0.57, P = 0.009) and FRR-BUB (r = 0.37, P =