Craig, G.M.; (2004) Mother knows best: Gastrostomy feeding in disabled children -- professional and parental discourses. Doctoral thesis , University of London.

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Abstract

This thesis explores professional and parental discourses in relation to gastrostomy feeding technologies. Drawing on resources from feminist poststructuralism as a rationale for interpreting women's accounts, it examines how these ideas can lend themselves to the study of parenting and feeding. Current clinical and research arenas bring health care providers, children and their families to make decisions about children's feeding. A prevalent medical discourse in feeding disabled children revolves around mabiourishment and poor growth, prompting a perception of the need for a gastrostomy feeding tube. Interviews with 22 mothers, between 1998 and 2001, formed part of an externally funded evaluation of gastrostomy feeding which the author was employed to coordinate. The author presents a deconstruction of the research study to explore how researchers mediate between different clinical and research discourses, and analyses how the subsequent political and ethical issues impact on children and their families. Women's accounts are analysed as constructing tube feeding as an intervention that either transforms their child by rendering her as 'other', or transforms their way of relating to the child, represented through oral feeding. Tube feeding was also constructed as an infringement of the child's rights to be involved and participate in social arenas, also associated with oral feeding. Both parents and clinicians constructed feeding decisions in terms of the child's best interests but, informed by competing and contradictory discourses, arrived at different conclusions about children's care. Parental accounts are analysed in terms of complex cultural-political overdeterminations between discourses of mothering, children's rights and normative child development. This analysis suggests that the clinical focus on weight-gain may underestimate women's concerns and has implications for how services support families. Drawing on reflexive methodological debates, the author highlights the needs and responses of researchers and clinicians, and indicates how these could be better addressed.

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