Parental issues in feeding young children with bronchopulmonary dysplasia.

This study examined the feeding issues that parents of 11 children with bronchopulmonary dysplasia (BPD) identified and explored the informational bases or criteria for decisions to initiate, continue, and/or terminate the feeding. An oral feeding by the parents was videotaped and replayed to assist in interviewing the parents regarding the decisions they had made during the feeding. Six types of feeding issues were identified. The smoothness or amenability of the child's feeding behavior was most frequently expressed as important, and about half of the parents mentioned the child's dietary intake as an issue. Most parents consistently tried to maintain the child's eating and to achieve a predetermined amount of nutritional intake. Over half the parents were concerned about adequacy of the child's nutrition, and many were concerned about their child's acceptance of or resistance to food. Parents did not express concern about their child's development but were concerned about their child's somatic growth. Parents' concern about feeding behaviors requires joint problem-solving by nurses and parents. Whether use of decision criteria that refer to the child's behavior rather than a predetermined amount of food is possible for parents and likely to contribute to reduced vomiting and resistive behavior and increased dietary intake needs further study.