Academic journal article Journal of Theory Construction and Testing

Toward a Theory of Feeding Efficiency for Bottle-Fed Preterm Infants

Academic journal article Journal of Theory Construction and Testing

Toward a Theory of Feeding Efficiency for Bottle-Fed Preterm Infants

Article excerpt

Abstract: Purpose: To propose a theory of feeding efficiency based on quantitative research reports using a literary synthesis method. Although researchers have not attempted to integrate this literature into a logical body ofknowledge, a synthesis of this knowledge could provide a systematic strategy for examining bottle feeding in preterm infants.

Sources: A final sample of 51 articles was selected through comp uter-assisted searches from 1966-2000, review of reference lists from selected articles and from review articles. Key words in the search included: bottle-feeding, infant premature, behavioral state, oxygen saturation, and heart and respiratory rate.

Methods: The literary synthesis process was used to identify a focal area, locate the statements, identify concepts and their linkages, generate higher order concepts, determine the sign and the directionality of the statements, identify organizing principles, and order statements by the organizing principles.

Findings: Infant health, physical characteristics, and external factors affect oral motor functioning and feeding performance thereby influencing infant outcomes. Oral motor function, also, affects the infants health. Developmental interventions are effective in improving oral motor function, thus improving feeding performance. The effect of feeding performance and developmental interventions on long-term infant outcomes is unclear.

Conclusion: A body of literature sufficient to theorize about feeding efficiency in preterm infants exists. There are unknown relationships among variables essential to feeding. These relationships need investigation during future testing of this theory

Key words: Bottle-feeding Efficiency Theory Feeding, Feeding Efficiency Preterm Infants, Bottle-fed

Successful bottle-feeding, a major milestone for preterm infants, is often used as an indicator of readiness for hospital discharge. One activity, the coordination of sucking-- swallowing-and-breathing, is essential in achieving this milestone. The successful coordination of these activities is influenced by the development of the lips, palate, jaw, tongue, pharynx, larynx, and esophagus in utero. Without satisfactory development of these structures, the infant will be unable to initiate bottle-feeding or synchronize the actions among the structures. The connection between sucking and swallowing is well established by 32 weeks station, but, the linkages between sucking and swallowing with breathing are not consistently achieved until around 37 weeks gestation (Bu'Lock, Woolridge, Baum, 1990).

Since the 1960s, researchers have examined the different characteristics of bottle-feeding and its influence on the health outcome of preterm infants. The complexity of the integration of bottle-feeding with the physiological and behavioral health of preterm infants has necessitated individual researchers to examine bottle-feeding using observables that represent only a portion of the domain of feeding. As evidence accrues from different scientists about a construct, such as feeding, it becomes possible to build a theory based on that evidence (Walker & Avant, 1995). The mounting body of research on bottle-feeding in preterm infants makes it possible to theorize about the observables related to feeding and to develop a model of feeding efficiency for preterm infants. Such a model provides a structure for examining the work of feeding and its affect on the health of preterm infants.

One method of theory construction, literary theory synthesis, collates empirical data from quantitative research studies to form a comprehensive pattern of the phenomena under study. This process involves using concepts, abstract or concrete, and statements, explicit or implicit, and arranging these parts in a logical fashion to constitute a pattern not clearly observed previously (Walker & Avant, 1995). By using this method of theory construction, a systematic organization of the body of literature related to feeding can be developed. …

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