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The Infant Feeding History: An Evidence-Informed 9-Item Structured History for Detecting Serious Illness in the
Joel Berezow1, Chrysalis Mandell2, Ellery H Schlingmann3
1Department of Emergency Medicine, Columbia University Medical Center, New York, New York, USA.
None:
Seriously ill infants frequently present to emergency departments with vague or nonspecific symptoms, making early identification of these patients challenging. Changes in feeding behavior are among the most reliable early indicators of pathology. This article outlines an evidence-informed, structured approach to the infant feeding history, proposing a 9-item tool to aid frontline providers in detecting life-threatening conditions. This tool utilizes the feeding history to evaluate an infant's vigor and hydration, and aids in the identification of red flags for serious or life-threatening conditions. Normative feeding patterns by age are provided to contextualize deviations. This evidence-informed framework is intended to standardize and strengthen feeding history assessment; prospective studies are needed to validate its diagnostic performance and determine whether a scoring threshold or abbreviated version is feasible. By integrating this tool into clinical practice, providers may be able to improve diagnostic accuracy, reduce missed diagnoses, and enhance parental counseling and anticipatory guidance at discharge from the emergency department.
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