Comparison of two tools to assess dyad feeding interaction in infants with gastroesophageal reflux disease

J Spec Pediatr Nurs. 2018 Jan;23(1). doi: 10.1111/jspn.12203. Epub 2017 Dec 4.

Abstract

Purpose: The aim of this study was to compare the Mother-Infant/Toddler Feeding Scale (MITFS) and the Nursing Child Assessment Feeding Scale (NCAFS). Specific questions were as follows: (1) Are there differences between the results of the MITFS and the NCAFS tools in terms of rating infant feeding interactions? And (2) does one tool provide a more detailed, nuanced overview of the quality of feeding interactions than the other?

Design and methods: This comparative descriptive study is a secondary analysis of a study evaluating a massage intervention for infants with symptoms of gastroesophageal reflux disease (GERD). A feeding observation for each dyad was scored using both the NCAFS and MITFS. Infants were 6-18 weeks of age.

Results: There were moderate correlations (r = 0.3-0.8) between 11 of 20 possible NCAFS and MITFS mother-related subscales, and between 3 of 10 possible NCAFS and the MITFS infant-related subscales. A total of 19 dyads (83%) had one or more NCAFS subscale scores that were at least 1 standard deviation (SD) below normative scores, and 21 dyads (91%) had one or more MITFS subscale T-scores that deviated 1 SD from the normative T-scores. Agreement between the two instruments on scores deviating from the norm was 78%.

Practice implications: Both instruments discussed in this paper are standardized ways of assessing an infant feeding. Use of a standardized feeding tool is an objective way to evaluate feedings and can potentially identify specific areas of concern to guide an individualized intervention for a mother-infant dyad. Thus, nurses and other health professionals working with mothers and babies, whether in the hospital, pediatrician offices, or clinics would benefit from learning how to use a standardized feeding tool. Use of a feeding tool also provides the opportunity for nurses to understand the basis of important qualities of a feeding interaction, and a way for nurses who regularly feed infants to self-evaluate their feeding methods. This may minimize less than optimal interactions and allow for optimal support for infants during feedings by mothers and nurses.

Keywords: GERD; NCAST; feeding tools; infant.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Bottle Feeding / methods
  • Child Development / physiology
  • Feeding Behavior
  • Feeding Methods*
  • Female
  • Follow-Up Studies
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / therapy*
  • Humans
  • Infant
  • Male
  • Massage / methods*
  • Mother-Child Relations / psychology*
  • Nursing Assessment
  • Sampling Studies