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Establishing Normative Values for Healthy Term Infant Feeding Performance: Neonatal Eating Assessment Tool-Mixed,
Katlyn Elizabeth McGrattan1,2, Alicia Hofelich Mohr3, Ellen Weikle1
1Department of Speech-Language-Hearing Science, University of Minnesota, Minneapolis.
Insights
This study establishes normative feeding performance data for healthy infants using three common clinical assessments. These benchmarks are crucial for differentiating typical infant feeding from potential impairments.
Area of Science:
- Pediatric feeding and swallowing
- Infant development
- Clinical assessment validation
Background:
- Infants with feeding issues often undergo assessments, but data on healthy infants is limited.
- This gap hinders accurate diagnosis of feeding impairments.
- Understanding typical infant feeding is vital for clinical decision-making.
Purpose of the Study:
- To characterize the feeding performance of healthy, non-dysphagic term infants.
- To establish normative values for three common infant feeding assessments: Neonatal Eating Assessment Tool-Mixed (NeoEat-Mixed), Oral Feeding Scale (OFS), and Early Feeding Skills (EFS).
Main Methods:
- Prospective study of 30 healthy term infants.
- Video-monitored bottle feeding under normal conditions.
- Evaluations included caregiver perception (NeoEat-Mixed), milk intake (OFS), and feeding behaviors (EFS) by speech pathologists.
Main Results:
- Infants averaged 7 ml/min milk transfer rate and 50% modified proficiency.
- Most achieved mature scores on OFS (93%) and EFS for absence of color change (97%).
- However, 63% displayed stress cues, scoring immature on EFS, despite caregivers reporting normal feeding.
Conclusions:
- Normative data for NeoEat-Mixed, OFS, and EFS in healthy infants are presented.
- These benchmarks aid in distinguishing true feeding impairments from normal developmental variations.
- The presence of stress cues in healthy infants warrants further investigation.
Purpose:
Infants with perceived feeding problems are frequently referred for assessment of their feeding abilities. However, little is known regarding how healthy nondysphagic infants perform on commonly used assessments, making determination of impairment difficult. The aim of this investigation was to elucidate the characteristics of healthy term infant feeding performance using three commonly employed clinical assessments: Neonatal Eating Assessment Tool-Mixed (NeoEat-Mixed), Oral Feeding Scale, and Early Feeding Skills (EFS).
Method:
In this prospective case-control study, we recruited 30 infants without feeding impairments to undergo video-monitored bottle feeds under their normal feeding conditions. Caregiver perception of infant feeding was evaluated using the NeoEat-Mixed. Milk ingestion was monitored real time using the Oral Feeding Scale for rate of milk transfer and modified proficiency as characterized by the total volume consumed out of the total volume the caregiver provided. Videos were analyzed by two speech pathologists using the EFS assessment. Descriptive statistics were used to characterize performance.
Results:
Participants underwent feeding monitoring at an average chronological age of 4 ± 2 months. Caregivers primarily reported normal, nonconcerning feeding patterns across all of the NeoEAT-Mixed outcomes. Infants consumed milk at an average rate of transfer of 7 ± 3 ml/min, a modified proficiency of 50 ± 21%, and achieved the highest OFS score of 4 (93%, n = 28). The majority of infants scored the best EFS score (mature-3) as it related to the absence of color changes during the feed (97%, n = 29), although commonly scored in the worst EFS score (immature-1) in their presentation of one or more compelling stress cues (63%, n = 19).
Conclusion:
Establishing healthy term infant normative values for commonly used feeding assessments is critical in accurately distinguishing infants with feeding impairments from those with normal developmental variants.
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