Family Interactions Surrounding Feedings of Infants With Nonorganic Failure to Thrive

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Abstract
Family interactional processes surrounding infant feedings in 34 consecutive cases of nonorganic failure to thrive (NFT) admitted to a university teaching hospital are reported. Observations of family interactions for 90 minutes, including one feeding, yielded clinically useful information not readily available from other sources. Behaviors that supported inadequate feedings were reliably identified in 79 percent of the families. Failure of mothers to appropriately respond to their infants' cues, coupled with few signs of emotional attachment, were present in only 26 percent of cases, and inadequate child-care knowledge and skills in only 6 percent. Thus, widely held conceptual models explained perpetuation of inadequate feedings in only 32 percent of cases. Instead, sibling rivalry, displaced maternal anger, and undermined mother were among the problems found. Assessments of family members' interactions surrounding feedings have the potential to enhance the current management of NFT.

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