Assessment Tools for Evaluation of Oral Feeding in Infants Younger Than 6 Months

Abstract

Background Feeding difficulty is common in infants less than six months old. Identification of infants in need of specialized treatment is critical to ensure appropriate nutrition and feeding skill development. Valid and reliable assessment tools help clinicians objectively evaluate feeding. Purpose To identify and evaluate assessment tools available for clinical assessment of bottle- and breast-feeding in infants less than six months old. Methods/Search Strategy CINAHL, HaPI, PubMed, and Web of Science were searched for “infant feeding” and “assessment tool.” The literature (n=237) was reviewed for relevant assessment tools. A secondary search was conducted in CINAHL and PubMed for additional literature on identified tools. Findings/Results Eighteen assessment tools met inclusion criteria. Of these, seven were excluded because of limited available literature or because they were intended for use with a specific diagnosis or in research only. There are 11 assessment tools available for clinical practice. Only two of these were intended for bottle-feeding. All 11 indicated they were appropriate for use with breast-feeding. None of the available tools have adequate psychometric development and testing. Implications for Practice All of the tools should be used with caution. The Early Feeding Skills Assessment and Bristol Breastfeeding Assessment Tool had the most supportive psychometric development and testing. Implications for Research Feeding assessment tools need to be developed and tested to guide optimal clinical care of infants from birth through six months. A tool that assesses both bottle- and breast-feeding would allow for consistent assessment across feeding methods.

Age‐based norm‐reference values for the Child Oral and Motor Proficiency Scale

“…Feeding difficulties are common in young children, with reports of 25% of typically developing children and up to 80% of children with developmental delays experiencing problematic feeding . Identification of children with problematic feeding and timely referral to feeding specialty care has been limited by a lack of valid and reliable measures . The Child Oral and Motor Proficiency Scale (ChOMPS) is a valid and reliable parent‐report assessment of eating, drinking and related skills in children six months to seven years old that can be used to identify children with eating skill delays .…”

Development of a clinical feeding assessment scale for very young infants in South Africa

“…In a review of oral feeding assessment instruments for infants younger than 6 months, the findings of Pados et al . ( 2016 ) support the identification of this need. They concluded that there is a need for the development and testing of feeding assessment tools for young infants to guide optimal clinical practice.…”

“…Infants discharged with inadequate investigation into the feeding difficulties or unresolved feeding difficulties, LBW and prematurity are more at risk of developing failure-to-thrive than their term counterparts with appropriate weight for age (Browne & Ross, 2011 ). Valid and reliable assessment instruments will help clinicians to objectively evaluate feeding (Pados et al ., 2016 ).…”

Preliminary psychometric performance of the Neonatal Feeding Assessment Scale

“…Pados, Park, Estrem and Awotwi ( 2016 ) found a lack of validated feeding assessment scales for infants younger than 6 months that are supported by high level evidence in a recent review. They concluded that the Early Feeding Skills Assessment Instrument (EFS) was one of the instruments that had some supportive psychometric development and testing in the neonatal population.…”

“…Other risk factors contributing to feeding difficulties were HIV exposure in utero or during delivery (30%, n = 6), respiratory distress syndrome (55%, n = 11) and hyperbilirubinaemia (55%, n = 11). Prematurity (80%, n = 16) and LBW (85%, n = 17) were the most significant known risk factors for OPD (Pados et al, 2016 ).…”