Academic journal article ABNF Journal

Mothers' Perceptions of Child Vulnerability in Previous Preterm Infants

Academic journal article ABNF Journal

Mothers' Perceptions of Child Vulnerability in Previous Preterm Infants

Article excerpt

Abstract: This research examined whether the same predictive variables of mothers' perceptions of child vulnerability are present for extremely low birth-weight (ELBW) and very low birth-weight (VLBW) infants. Data were collected using 120 infants and 119 mothers. In ELBW infants, days until first bottle feeding, feeding problems, and feeding practices accounted for 69.9% of the variance (p<.001)atfour months; feeding problems 49.9% (p<.00l) at six months; and days until the first bottle feeding and feeding problems were 41.9% (p<.00l)at twelve months. In the VLBW infants, feeding problems and length of stay accounted for 46.9% of the variance (p<.00l) at four months; infant length of stay was 15.1% (p<.001) at six months; and there was no significance at twelve months. Mothers' perceptions of child vulnerability can be predicted at four, six and twelve months. The predictive variables may depend on the birth weight category of the infant.

Key Words: Perceptions, Child Vulnerability, Extreme Low Birth Weight, Very Low Birth Weight, Infants, Feeding

For more than a decade researchers have shown that parents of premature infants often perceive their infants as medically vulnerable, even after their health improves (Forsyth & Canny, 1991 ; Allen, Manuel, Legault, Naughton, Pivor, and O'Shea (2004). According to Pearson & Boyce (2004), these infants often have multiple risk factors including jaundice, feeding, and crying behavior that lead to heightened parental perception of child vulnerability, that is thought to prompt excessive health concerns such as problems that influence feeding. During the first few months of life (known as the formative period for parents and infants), parents develop thoughts and feelings about the infant's personality, behavior, and strengths. It is believed that during this era, long term effects on the parent's perception become evident. These problems may also become evident during the child's physical and psychological well-being.

Feeding problems are common among infants with medical conditions, especially in gastro-esophageal reflux disease (GERD), and those bom pre-term (Rommel, DeMeyer, Feenstra, and Veereman-Wauters (2003). Pulsifer-Anderson (2009), Vandenplas, Rudolph, Di Lorenzo, Hassall, Loptak, Mazur, Sondheimer, Staian,Thomson, Veereman-Wauters, and Wenzl (2009), and Ross & Browne (2013) feel that these infants tend to have fewer readiness behaviors for solid foods, and more food loss with refusals. They appear to be more demanding and difficult to feed. During the one year follow-up, infants were apt to take more than an hour to eat, with parents becoming upset during meal times. Thirty month old children who had swallowing problems, refused food, or had nasogastric or gastrostomy feeding tubes, showed to have poor growth in weight and head circumference (Wood, Costeloe, Gibson, Hennessy, Marlow, and Wilkinson (2003). Poor head circumference growth was not correlated with neurological disability. Researchers have also shown when compared to full term infants, ELBW infants were at the 9th percentile in weight at six months, but the 7th percentile in twelve months. The lengths of the ELBW infants showed similar lags at six months (8th percentile) and twelve months (9th percentile), while the head circumference lagged at the 21st percentile at six months and at the 20th percentile at twelve months. The percentiles for each growth parameter in the ELBW infants were significantly below those in the full term infants at the six and twelve month assessment periods (Hill et al. 2009). Wood et al. (2003) noted that poorer growth was found in children whose parents reported feeding problems in the infants who were oxygen dependent (a marker for neonatal respiratory illness) for long periods of time. With these factors understood, parents' perceptions may still be factors in the child's outcomes, especially when the infants bom with extremely low birth weights and very low birth weights are not clearly defined. …

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