1. Beal, Judy A. DNSc, PNP, RN
  2. Freda, Margaret Comerford EdD, RN, CHES, FAAN

Article Content

Pridham, K., Saxe, R., & Limbo, R. (2004). Journal of Perinatal and Neonatal Nursing, 18(2), 161-170.

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Adequate feeding of very low birth-weight (VLBW) premature infants is the primary concern for most parents and clinicians throughout the NICU stay and even the first year. This study explores the well-known belief that how parents describe their feeding experiences makes a difference in how both families and nurses approach feeding issues. The concept of internal working models of parenting as first described by Bowlby (1982) is applied to the feeding experiences of three families. This model proposes that parents have a mental model of expectations of how their feeding experiences should be and that this, in turn, impacts intentions, behaviors, and responses to these experiences. Using a case study approach, this study describes in great detail the feeding experiences of three mothers who are part of a larger randomized clinical intervention study designed to test the effectiveness of nursing interventions to support mothers' competencies for feeding a VLBW premature infant through the first year of life. From this larger study, three mothers who represented variations in working models of parenting for whom feeding issues were most predominant were selected. Case analysis was conducted according to the methods described by Miles and Huberman (1994). Consistent with case study approaches, the results included rich narrative detail on the cases; in this study, this was the working model of parenting. The working models of the three mothers included, for one mother, expectations and the need to be a more successful feeder than others; in another mother, this included disappointment with herself and her infant and frustration and hopelessness about unsuccessful feeding and growth; and finally, for the third mother, the model focused on feelings of inadequacy and the inability to impact her baby's successful feeding experiences. The authors concluded that it is critical for nurses to identify a mother's working model to better understand what the barriers and facilitators of effective feeding for each mother are. Knowledge of these factors will assist the nurse in providing appropriate interventions for support and teaching. Future research is needed with larger samples to identify common working themes of parenting around feeding issues of VLBW premature infants.


Comment by Judy Beal




1.Bowlby, J. (1982). Attachment. New York: Basic Books. [Context Link]


2.Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis. (2nd ed.). Thousand Oaks, CA: Sage. [Context Link]