Feeding problems in infancy and early childhood: evolutionary concept analysis.
OBJECTIVE
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.


METHODS
An evolutionary concept analysis.


METHODS
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.


CONCLUSIONS
A spectrum conceptualization of feeding problems is suggested for further development, with attributes that would be critical to have a feeding problem.
School of Nursing, Duke University, Durham, North Carolina, USA.
Hayley H
http://orcid.org/0000-0003-2599-8893
HH
Estrem
School of Nursing, University of North Carolina at Chapel Hill, North Carolina, USA.
Britt F
BF
Pados
Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA.
Jinhee
J
Park
University of North Carolina at Chapel Hill, North Carolina, USA.
Kathleen A
KA
Knafl
University of North Carolina at Chapel Hill, North Carolina, USA.
Suzanne M
SM
Thoyre
D002675:Child, Preschool; D005247:Feeding Behavior / Q000523:psychology*; D005248:Feeding Methods / Q000523:psychology*; D019959:Feeding and Eating Disorders of Childhood / Q000145:classification* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D015995:Prevalence
concept analysis; enteral feeding; feeding behaviour; midwives; nurses; nursing