Feeding problems in infancy and early childhood: evolutionary concept analysis
Hayley H Estrem1, Britt F Pados2, Jinhee Park3
1School of Nursing, Duke University, Durham, North Carolina, USA.
Insights
Pediatric feeding problems lack a unified definition, hindering research. A spectrum conceptualization is proposed to better understand and address these complex issues in children.
Area of Science:
- Pediatrics
- Concept Analysis
- Child Health
Background:
- Pediatric feeding problems and disorders lack a shared conceptualization.
- Inconsistent definitions and diagnoses limit the study of etiology, prevalence, and incidence.
- Existing definitions often lack practical utility for clinical and research purposes.
Purpose of the Study:
- To conduct an evolutionary concept analysis of pediatric feeding problems.
- To identify and analyze the core concepts, attributes, and consequences related to pediatric feeding problems.
- To propose a refined conceptualization for improved understanding and management.
Main Methods:
- Evolutionary concept analysis methodology.
- Comprehensive literature search across multiple databases (Google Scholar, CINAHL, PubMed, Web of Science) in October 2014.
- Analysis of 266 articles, with a focus on 100 recent articles coded for key conceptual elements.
Main Results:
- Historical analysis reveals a pattern of parental blame in pediatric feeding problems.
- Current literature shows diverse, yet unvalidated and generalizable, typologies.
- Consensus attributes include problematic feeding behaviors and selective/restrictive intake.
Conclusions:
- A spectrum conceptualization of pediatric feeding problems is suggested for future development.
- This approach aims to define critical attributes for identifying feeding problems.
- Further research is needed to validate and refine this conceptual model.
Aim:
The aim of this study was to report an analysis of the concept of pediatric feeding problems.
Background:
Reviews of the literature on pediatric feeding problems and disorders repeatedly reference the lack of a shared conceptualization of feeding problems. It is difficult to track aetiology, prevalence and incidence of a phenomenon when available definitions and diagnoses lack practical utility.
Design:
An evolutionary concept analysis.
Data Sources:
A search was conducted in October 2014 of Google Scholar, CINAHL, PubMed and Web of Science databases, with MeSH terms and key words including: failure to thrive, feeding disorder/difficulty/problems, infantile anorexia, oral aversion, mealtime behaviour and dysphagia. Inclusion criteria were: subject of feeding problems, index children 0-10 years of age, English language and full text.
Methods:
The articles (n = 266) were sorted into disciplines of authorship, including Psychology, Medicine, Nursing, Nutrition, Occupational Therapy, Speech Language Pathology or Other. The sample was divided into a historical sample (n = 42) for pre-2000 articles and current for those published post-2000. The current sample was later reduced to 100 and coded for surrogate terms, related concepts, attributes, antecedents and consequences.
Results:
The historical view of pediatric feeding problems shows a tradition of mother blame or parental culpability, both direct and indirect. Currently, there exist many different definitions and typologies, but none have sound validity or generalizability. Areas of attribute consensus across disciplines are problematic feeding behaviours and selective or restrictive intake.
Conclusion:
A spectrum conceptualization of feeding problems is suggested for further development, with attributes that would be critical to have a feeding problem.
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