Graduation Year
2022
Document Type
Dissertation
Degree
Ph.D.
Degree Name
Doctor of Philosophy (Ph.D.)
Degree Granting Department
Nursing
Major Professor
Denise Maguire, Ph.D., RN, FAAN
Committee Member
Genieveve Cline, Ph.D., DNP, APRN, NNP-BC, CNE, NPD-BC
Committee Member
Allyson Duffy, Ph.D., RN
Committee Member
Emily Shaffer-Hudkins, Ph.D., NCSP
Keywords
Neonatal Opioid Withdrawal Syndrome, Neonatal Abstinence Syndrome, Maternal Sensitivity, Caregiving
Abstract
Infants diagnosed with neonatal opioid withdrawal syndrome (NOWS) exhibit neurobehavioral dysregulation that may make them challenging to feed, potentially impeding positive early maternal-infant interactions. The goal of this study was to investigate dyadic behavior during the maternal-infant feeding interaction, specifically infant dysregulation and maternal sensitivity, between dyads with opioid exposure in the neonatal intensive care unit (NICU). This was a secondary data analysis using a mixed-methods design to analyze videorecorded feeding interactions of mothers with opioid use disorder (OUD) and their infants with NOWS. An integrative literature review investigating maternal sensitivity in mothers with OUD was conducted. Verbalizations expressed by mothers to their infants during the recorded feedings were transcribed and analyzed using thematic analysis. The videos were also coded using the Mother-Infant Feeding Tool (MIFT) to assess infant dysregulatory behaviors and maternal responses. Relationships between the MIFT codes, demographics, perceived stress, and previously reported Nursing Child Assessment Feeding Scale (NCAFS) scores were examined.
Most evidence indicates that mothers with OUD display lower maternal sensitivity than non-substance exposed mothers. Verbalizations expressed by mothers during the feedings consisted of mostly praise and encouragement, while some comments indicated mothers had difficulty interpreting infant cues and were concerned that the newborn had to finish their entire feed volume prescribed by the NICU medical team. Clarity of infant cues was related to the infant’s regulatory state and support provided by the mother during the feeding. Not supporting the infant during the feeding and infant dysregulatory behavior was correlated with higher maternal perceived stress.
Clinicians should be able to identify infant cues as well as withdrawal signs, assess maternal responses, and offer intervention to support the maternal-infant feeding interaction if needed. Mothers must be educated on infant cues and techniques to support infant regulation and reduce maternal stress. While the small sample size limits the generalizability of the results, the findings of this study indicate that further research is needed into early maternal-infant interactions and feeding experiences of dyads with opioid exposure.
Scholar Commons Citation
Rinaldi, Kailey T., "A Mixed Methods Analysis of Maternal-Infant Feeding Interactions Between Dyads with Opioid Exposure" (2022). USF Tampa Graduate Theses and Dissertations.
https://digitalcommons.usf.edu/etd/10348
