Feeding Skills Assessment Research Articles

Changes in Oral Feeding in Preterm Infants 2 Weeks After Hospital Discharge

The purpose of this analysis was to measure changes in preterm infant feeding skill between discharge and two weeks post-discharge. Data were from 2 samples—22 preterm infants who participated in a non-experimental study of feeding readiness and 63 preterm infants who participated in a study of four oral feeding approaches. Both studies were approved by the institutional review board; parents gave informed consent. The Early Feeding Skills Assessment was used to measure feeding skills. Data were analyzed descriptively and by analysis of variance and regression. Analysis revealed that feeding skills changed selectively from discharge to post-discharge and that discharge skills were predictive of post-discharge skill. Changes that occur in feeding skills during the immediate post-discharge period have received little attention from researchers. The findings suggest that enhanced predischarge assessment and parent teaching maybe necessary to reduce reported parental stress associated with feeding the newly discharged infant and to promote a positive feeding experience.

Trajectories of Parasympathetic Nervous System Function Before, During, and After Feeding in Infants With Transposition of the Great Arteries

Compromised parasympathetic response to stressors may underlie feeding difficulties in infants with complex congenital heart defects, but little is known about the temporal pattern of parasympathetic response across phases of feeding. The aim of this study was to describe initial data exploration of trajectories of parasympathetic response to feeding in 15 infants with surgically corrected transposition of the great arteries and to explore the effects of feeding method, feeding skill, and maternal sensitivity on trajectories. In this descriptive, exploratory study, parasympathetic function was measured using high-frequency heart rate variability (HF HRV), feeding skill was measured using the Early Feeding Skills assessment, and maternal sensitivity was measured using the Parent-Child Early Relational Assessment. Data were collected before, during, and after feeding at 2 weeks and 2 months of age. Trajectories of parasympathetic function and relationships with possible contributing factors were examined graphically. Marked between-infant variability in HF HRV across phases of feeding was apparent at both ages, although it was attenuated at 2 months. Four patterns of HF HRV trajectories across phases of feeding were identified and associated with feeding method, feeding skill, and maternal sensitivity. Developmental increases in HF HRV were apparent in most breast-fed, but not bottle-fed, infants. This exploratory data analysis provides critical information in preparation for a larger study in which varying trajectories and potential contributing factors can be modeled in relationship to infant outcomes. Findings support inclusion of feeding method, feeding skill, and maternal sensitivity in modeling parasympathetic function across feeding.

Assessment and Management Considerations for Oral Feeding of the Premature Infant on the Neonatal Intensive Care Unit

Assessment and Management Considerations for Oral Feeding of the Premature Infant on the Neonatal Intensive Care Unit

The early feeding skills assessment for preterm infants.

Preterm infants develop the skills necessary to begin oral feeding as their health stabilizes and as they reach a postconceptional age that supports coordination of breathing and swallowing with oral-motor functioning. The time from initiation of oral feeding to full oral feedings (with adequate intake for growth and maintenance of physiologic stability) can vary from days to months for the preterm infant. The approach to feeding the infant during this transition period must be developmentally supportive and tailored to meet the needs of the individual. To accomplish this, caregivers--notably nurses and parents--need to communicate about the specific skills that the infant has gained, about skills that are emerging, and about skills that the infant has not yet developed. The Early Feeding Skills (EFS) Assessment is a checklist for assessing infant readiness for and tolerance of feeding and for profiling the infant's developmental stage regarding specific feeding skills: the abilities to remain engaged in feeding, organize oral-motor functioning, coordinate swallowing with breathing, and maintain physiologic stability. This article introduces the EFS.

Assessment of Feeding Skills in Patients With Alzheimer’S Disease

Individuals with Alzheimer's disease (AD) and other dementias are at risk of nutritional compromise due to behavioral factors that interfere with regular eating patterns. Persons with AD may be unwilling or unable to eat independently, and may require assistance ranging from verbal supervision to total hand feeding to ensure adequate dietary intake. Assessment of feeding skills of AD patients can aid dietitians and other healthcare professionals in providing optimal nutrition care for these individuals. This research tested the reliability and validity of a feeding skills assessment tool developed by geriatric researchers for the purpose of detecting feeding difficulties and classifying patients based on feeding assistance needed (Volicer et al., 1989). An expert panel experienced in nutrition care for the elderly reviewed the tool for content validity. Three raters, a dietitian, a dietary manager, and a nurse/care plan coordinator, rated nine patients in a dedicated Alzheimer's unit of a long-term care facility at two mealtimes. Percentage of observer agreement ranged from 26% to 100% on the 24 items, with an overall agreement of 58%. Test-retest reliability ranged from 0.12 to 1.00, with an overall rating of .57. This tool thus yielded moderately consistent ratings of patient feeding skills when different raters assessed those skills. Raters made recommendations for modifications to the tool that could improve its reliability, such as altering the rating scale and omitting items with poor reliability or limited applicability to patients in varying stages of disease progression. Routine assessment of feeding skills of Alzheimer's and other dementia patients with a valid and reliable assessment tool can aid healthcare personnel in identifying feeding difficulties and developing an appropriate care plan to optimize nutritional well-being.

Nutritional status of institutionalized children and adolescents with developmental disabilities

The relationship was explored between anomalies associated with developmental disabilities and nutritional status of institutionalized children and adolescents who received comprehensive interdisciplinary services. Variables included dietary intake, serum laboratory values, anthropometric measurements, feeding skills assessment, and clinical assessment. Mean intakes of nutrients were greater than 67% of Recommended Daily Allowances. Laboratory values were within normal ranges with the exceptions of serum ferritin, which was borderline or below normal in 46% of the males and 55% of the females, and alkaline phosphatase, which was elevated in 70% of residents receiving anticonvulsants. Energy intake was highest in residents with adequate feeding skills, followed by nonfeeders and feeders requiring behavior management. Subjects had greater triceps skinfold and lower mid-arm muscle circumference and weight measurements as compared to reference data. Findings of this study suggest that these developmentally disabled children and adolescents who received comprehensive interdisciplinary nutritional services, in general, are adequately nourished and have nutrient intakes that meet the RDA requirements.

A behavioral approach to the training and assessment of feeding skills in multihandicapped children.

In the present study, a behavioral program for training feeding skills was evaluated using a multiple-baseline experimental design. Six hospitalized mentally retarded-behaviorally disordered children served as subjects. Three groups of two subjects each were instructed in three feeding skills: chewing with mouth closed, appropriate utensil use, and appropriate napkin use. Training consisted of praise for appropriate display of target behaviors; on occurrence of inappropriate behavior, the following sequence was carried out: 10-second time-out; instruction in appropriate behavior including modeling and manual guidance; and behavioral rehearsal. Results indicated positive behavior change in training sessions and in immediately succeeding sessions during which training was withheld. Furthermore, behavioral gains were judged to be clinically significant by a group of independent observers. Modest generalization and maintenance of training effects were also evidenced.