title: Patterns of Disruptive Feeding Behaviors in Infants With Neonatal Abstinence Syndrome.
abstract: BACKGROUND
  Severe irritability in infants with neonatal abstinence syndrome often impacts their ability to feed successfully, which challenges a mother's ability to demonstrate this most basic parenting skill. There is little empiric evidence to guide recommendations for practice in this population.
  
  
  OBJECTIVE
  Describe the infant behaviors that disrupt feeding in infants with neonatal abstinence syndrome.
  
  
  METHODS
  A mixed-method approach was used to describe digitally recorded infant feeding behaviors. Qualitative methodology was first used to identify categories of behaviors during the feeding. The categories were used as a coding scheme to identify the temporal sequence, duration, and frequency of behaviors observed during a feeding.
  
  
  RESULTS
  The behavior categories that disrupted feeding were identified as fussing, resting, crying, and sleeping/sedated. Infants spent almost twice as much time in fussing as in feeding. The majority of the infants were fussing between 1 and 11 minutes during the feeding, and fussing disrupted feeding in every subject at least once. Feeding behavior occurred only 24% of the time, while fussing and crying occurred 51%. Fussing was the primary transitional behavior from one category to another. Infants who did not complete their feeding had nearly twice the mean number of fussing episodes as those who completed their feeding.
  
  
  CONCLUSIONS
  Fussing is a transitional state and appears to provide an opportunity to test interventions that help the mothers re-engage their infants in feeding. The frequency of the behavioral transitions provides a measure of irritability that has not been previously described in this population.
  
  
  CONCLUSIONS
  Additional study is needed to evaluate the impact and contributions of maternal behaviors and external variables on infant behavioral transition.
authors: College of Nursing, University of South Florida, Tampa (Drs Maguire, Spring, and Elliott); Leona and Lewis Hughes Endowed Chair for Nursing Science, College of Nursing, USF, Tampa, Florida (Dr Rowe).
authors: Denise J
authors: DJ
authors: Maguire
authors: Meredeth A
authors: MA
authors: Rowe
authors: Heather
authors: H
authors: Spring
authors: Amanda F
authors: AF
authors: Elliott
mesh_terms: D000328:Adult; D003448:Crying; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D018730:Infant Behavior / Q000523:psychology*; D007231:Infant, Newborn; D008297:Male; D009020:Morphine / Q000008:administration & dosage; D009357:Neonatal Abstinence Syndrome / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000523:psychology; D000066553:Problem Behavior; D012890:Sleep; D055815:Young Adult
chemical_list: D009020:Morphine