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An Interdisciplinary Feeding Team Approachfor Preterm, High-Risk Infants and Children
Jan H. Geggie1, Donna L. Dressler-Mund, Dianne Creighton
1RD, Clinical Nutrition Services, Alberta Children's Hospital, Calgary, AB.
Insights
High-risk infants often struggle with oral feeding, requiring specialized, interdisciplinary care. A Perinatal Feeding Team approach, integrating nutrition and therapy, effectively addresses these complex feeding challenges.
Area of Science:
- Pediatrics
- Developmental Psychology
- Clinical Nutrition
Background:
- Infants and children with poor oral feeding abilities present complex challenges requiring multidisciplinary intervention.
- These challenges impact nutrition, growth, feeding skills, behavior, and family well-being.
Purpose of the Study:
- To describe the experiences and assessment format of a Perinatal Feeding Team.
- To outline the frequency and types of interventions for high-risk children with feeding difficulties.
- To report on the development of the Oral Eating Readiness Assessment List (ORAL(c)).
Main Methods:
- Retrospective review of 33 patients referred to the Perinatal Feeding Team over 18 months.
- Utilized preassessment tools for problem identification.
- Involved a multidisciplinary team including dietitians, occupational therapists, and psychologists.
Main Results:
- Most frequent reasons for assessment included oral sensorimotor dysfunction, decreased growth velocity, feeding delay, aversive feeding reactions, and parental stress.
- Recommended interventions focused on nutrition counseling (97%), feeding skill progression (90.9%), and sensorimotor function normalization (84.8%).
Conclusions:
- A collaborative, interdisciplinary approach is crucial for managing multifaceted feeding difficulties in high-risk children.
- The development of the Oral Eating Readiness Assessment List (ORAL(c)) supports comprehensive assessment.
- Individualized, parent-centered care plans are essential for successful outcomes.
Abstract:
Poor oral feeding abilities in high-risk infants and children require interdisciplinary assessment and treatment in relation to nutrition, growth, oral feeding skills, behavioural interactions, and family coping. This paper describes the Perinatal Feeding Team's experiences, the format of our assessments, and the frequency of interventions recommended for 33 patients referred over 18 months. The most frequent reasons for assessment were suspected oral sensorimotor dysfunction/disorganization, decreased growth velocity, and feeding skills delay (each 18.3%); aversive reactions to feeding (14%) and significant parental stress around feedings (13.3%). Preassessment tools facilitated identification of relevant feeding problems. The dietitian, occupational therapist, psychologist, and parents played specific roles in providing a comprehensive feeding assessment. Interventions most frequently recommended were nutrition counselling (97%), food texture and feeding skill progression (90.9%), and normalizing sensorimotor function (84.8%). These findings led to the development of the Oral Eating Readiness Assessment List (ORAL(c)). Coordinated care plans are individualized and prioritized with parents. Our collaborative approach to multifaceted feeding difficulties in a follow-up clinic for preterm, high-risk children continues to evolve as we learn more about the needs of these children and their families.