Psychometric properties of the Parental Feeding Behaviours Questionnaire for Indonesian parents of young children

Purpose

The objective of this study was to test the psychometric properties of the Parental Feeding Behaviours Questionnaire (PFBQ) to measure feeding behaviours of Indonesian parents of toddlers (young children).

Methods

A total of 696 parents of toddlers were obtained by convenience sampling during September 2013 to April 2014. To validate the PFBQ, confirmatory factor analysis and the contrasted group technique were conducted. Reliability of this instrument was examined by construct reliability and test‐retest reliability.

Results

Results showed that the regression coefficients of all 56 indicators were statistically significant (P < 0.001). The contrasted group technique showed significantly different parental feeding behaviours between parents of well‐nourished and malnourished toddlers (P = 0.047). The test‐retest reliability of the PFBQ was acceptable (Pearson correlation = 0.644), and the construct reliability ranged from 0.88 to 0.96.

Conclusions

The PFBQ is a valid and reliable instrument; however, more studies are required to identify acceptable tools to measure more culturally diverse range of parental feeding behaviours.     

The Effects of Infant Feeding Decisions on Infant Growth

ISSUES AND PURPOSE. To determine the effects of feeding decisions on infant growth in the first 6 months of life.
DESIGN AND METHODS. Growth measurements were collected twice during the first 6 months of infancy as part of a larger investigation of infant feeding practices (N = 52).
RESULTS. Infants who received solid foods before the age of 4 to 6 months weighed less than those who received solid foods after 4 to 6 months. There were no differences in growth measurements between formula-fed and breastfed infants, although breast-fed infants weighed more at birth.
PRACTICE IMPLICATIONS. Emphasize the importance of feeding breast milk (preferably) or formula only for the first 6 months. Advise parents to withhold fruit juices until the infant is at least 6 months old.     

The Effect of the Inability to Intake Chewable Food Texture on Growth,Dietary Intake and Feeding Behaviors of Children with Cerebral Palsy

The study investigated growth, dietary intake and the feeding behaviors of children with cerebral palsy (CP) who could not manage chewable food textures. The study included 2 groups: a study group of children with CP whose diet did not consist of chewable foods, and a control group of typically developing children, who consumed all food. The International Dysphagia Diet Standardisation Initiative (IDDSI) was used during group allocation. Dietary assessment was performed using the 24-hour diet recall method; food type, amount ingested, and texture were considered to determine the IDDSI levels. The z-scores of nutritional indicators were calculated and a parent report instrument, the Behavioural Paediatrics Feeding Assessment Scale (BPFAS), was used to assess feeding behaviors. Eighty-five children were included. There was no differences between groups in terms of age (p=0.16) and sex (p=0.73). The mean weight (p=0.002) and height (p=0.011) for age Z-scores of study group were lower. Also in the study group, daily calorie and fat intakes were lower (p=0.038,p=0.011;respectively), whereas water from food and calcium intakes were higher (p=0.001,p<0.001,respectively). Feeding problems were determined in 48% of study group, whereas in 5.7% of the control group (p<0.001). Parents in the study group reported higher stress levels and more concerns about the child’s feeding behavior (p<0.001). Children with CP have deficits in their obtainment of the necessary nutrition and hydration. The inability to intake any chewable food may contribute to these problems, and also cause negative feeding behaviors, and more problematic perceptions by parents. Clinical Trial Registration Number: NCT02777645.     

Assessment of feeding performance in patients with cerebral palsy

Patients with cerebral palsy (CP) frequently manifest oral-ingestive problems ranging from mild to severe. Drooling, rejection of solid foods, choking, coughing and spillage during eating may contribute to these problems. The aim of this study was to assess functional feeding skills of patients with CP, aged 4-25 years. They were assessed with the Modified Functional Feeding Assessment Scale (FFAm). Mothers had expressed concern regarding drooling and reluctance in accepting solid foods. None of the mothers thought that there was a major problem with adequate ingestion. However, the study revealed that patients had disabilities in spoon feeding, biting, chewing, cup drinking, straw drinking, swallowing and clearing.     

澳门住院产妇婴儿喂养态度影响因素的研究

目的:探讨澳门住院产妇婴儿喂养态度的现状及其影响因素。方法:2009年12月至2011年12月,在澳门一间公立医院住院部,采用方便抽样法对468名华裔产妇在产后3天应用中文版婴儿喂养态度量表(IIFAS)进行横断面调查。结果:产后3天IIFAS总分为(58.94±6.21)分;多元线性回归分析发现有4个因素进入回归方程,其中产妇持有奶粉喂养意图、产后3天采取奶粉喂养方法、产妇的母乳喂养知识不充足与母乳喂养态度呈负相关(β=-0.267、-0.101、-0.087,P<0.05)。孕期接受过母乳喂养卫教与母乳喂养态度呈正相关(β=0.103,P<0.05)。产后3天IIFAS总分在产妇的教育程度、年龄、分娩方式、婚姻、家庭月收入、有无产假、是否饮酒、在澳门居住年限和有无喂奶经验等方面无统计学差异(P>0.05)。结论:澳门产妇的婴儿喂养态度处于中高水平,婴儿喂养态度总分越高越趋向于采取母乳喂养行动。婴儿喂养意图、孕期母乳喂养卫教、母乳喂养知识和产后早期婴儿喂养方式是影响澳门产妇婴儿喂养态度的主要因素。     

Factors affecting exclusive breastfeeding of healthy babies aged zero to four months: a community-based study of Turkish women

Aim. The purpose of this study was to determine the factors that affect exclusive breastfeeding of healthy babies aged 0–4 months. Background. Both the World Health Organization (WHO) and UNICEF recommend feeding babies of 0–6 months exclusively with breast milk and starting complementary foods after the sixth month. In Turkey, however, a vast majority of babies 1–5 months of age (89·4%) are given complementary foods. Methods. This cross‐sectional study was conducted in central Ankara province, with a sampling of 514 individuals who were selected using the convenience sampling method. Results. Of the 514 mothers who participated in my research, 260 (50·6%) were found to be feeding their babies exclusively with breast milk; 77 (15·0%), with breast milk + water; 87 (16·9%), with breast milk + baby formula; 70 (13·6%), with breast milk + baby formula + other foods; and 20 (3·9%), baby formula + other foods. Based on multivariate logistic regression analysis results, the mother's employment [odds ratio (OR) = 0·488; 95% confidence interval (CI) = 0·288–0·827) considerably reduced the incidence of complementary foods, while frequent crying of the baby (OR = 1·687; 95% CI = 1·125–2·530) significantly increased the use of supplementary foods in infant nutrition. Conclusion. This study concluded that frequent crying of the baby increases the likelihood of giving the baby complementary foods. Midwives and nurses can encourage exclusive breastfeeding behaviour by providing individual education and counselling to women whose babies cry frequently. Relevance to clinical practice. Exclusive breastfeeding of babies aged 0–6 months is crucial for the development and growth of the baby and instrumental in reducing infant morbidities and mortalities. One factor that increases the likelihood of provision of complementary foods is frequent crying of the baby. Midwives and nurses can encourage exclusive breastfeeding behaviour by providing individual education and counselling to women whose babies cry frequently.     

Reply: Accent Modification,Pronunciation Training,Communication Enhancement: the Need for Definitions,Delimitations, and Research

Abstract

Parents of children with Autism Spectrum Disorders (ASD) commonly report concerns regarding feeding difficulties and poor nutrition. Feeding difficulties, in the form of undesirable mealtime behaviours and/or skill deficits, can cause parental concern and impact on family dynamics. Poor nutrition can have an impact on development and health outcomes. The purpose of this paper was to review recent research regarding feeding difficulties in children with ASD, in order to describe: (1) the most frequently reported undesirable mealtime behaviours and skill deficits; and (2) dietary intake and weight patterns as markers of nutrition. While the ASD population is a somewhat heterogeneous group, this literature review of 44 research studies identified a number of common issues for these children. Restricted dietary variety, food neophobia, food refusal, limiting diet based on texture, and a propensity towards being overweight were frequently reported. Gaining a better understanding of the common features of feeding difficulties experienced by children with ASD will assist in directing intervention studies. Findings from such studies have the potential to enhance developmental and nutritional outcomes for this group. Well-designed longitudinal research would be valuable in monitoring the impact of feeding difficulties for these children as they age.     

Infant feeding attitudes of expectant parents: breastfeeding and formula feeding

BACKGROUND: Research has indicated that parental attitudes are strong predictors of choice of infant feeding. Identification and understanding of the infant feeding attitudes of mothers and their social networks should be an early step in the design and implementation of breastfeeding interventions. AIM: To compare the infant feeding attitudes of parents of breastfed infants with those of parents of formula fed infants. METHODS: A survey was carried out with a convenience sample of pregnant women (gestational age 8-12 weeks) attending three maternity clinics in Scotland in 2000. Expectant mothers and their partners (n = 108 couples) completed the 17 item Iowa Infant Feeding Attitude Scale. Demographic information was collected by face-to-face interview and the method of feeding at discharge from hospital was obtained from medical records. RESULTS: Parents of breastfed infants had more positive attitudes towards breastfeeding than parents of formula fed infants, and were more knowledgeable about the health benefits and nutritional superiority of breastfeeding. Fathers of both breastfed and formula fed infants were more likely than their partners to disapprove of women breastfeeding in public. Parents considered their chosen method of feeding to be the more convenient alternative. Mothers of formula fed infants were more likely to think that women who occasionally drink alcohol should not breastfeed. CONCLUSION: Parents of formula fed infants had several misconceptions about breastfeeding. Use of the Iowa Infant Feeding Attitude Scale could help health professionals identify and address these in infant feeding discussions in the early antenatal period. Efforts should be made to include fathers in these infant-feeding discussions.     

1985～2005年广州市7岁以下儿童体格发育调查分析

[目的]分析掌握广州市7岁以下儿童生长发育的规律，为保健、临床及科研工作提供儿童体格发育参考数据，为制定干预措施提供准确依据。[方法] 选择与1985年、1995广州市7岁以下儿童体格发育调查所选的调查点进行调查，按年龄组距要求随机整群抽样0～7岁广州市户籍汉族健康儿童，进行体格发育测量和自编问卷调查，采用描述性统计分析、t检验、逐步回归法进行资料分析 [结果] 1985～2005年广州市儿童的身高、体重呈现持续增长趋势。经过20年的追赶，我市儿童身高体重已达到世界平均水平，并且城区儿童身高体重已达到美国NCHS/WHO身高体重标准，郊区儿童在8个月以前达美国NCHS/WHO身高体重标准，但8个月以后则低于美国NCHS/WHO身高体重标准。以stepwise逐步回归法进行营养相关因素多重回归分析，最后进入方程变量为独立进食、定时进餐、固定位置进餐，奶瓶喂辅食频率。[结论] 目前广州市儿童体格发育仍处于加快上升阶段，但仍存在城乡、南北差别，环境因素如家庭经济收入、父母文化、喂养行为是儿童体格发育的主要影响因素，因此今后要加强科学喂养知识宣传，重视儿童饮食技能习惯培养，重点是农村地区，以保证儿童营养，促进儿童生长潜能的发挥。     

早产儿喂养不耐受的相关因素分析

目的:探讨早产儿喂养不耐受的相关因素,为降低不耐受发生率提前采取措施。方法:对134例早产儿的喂养不耐受发生率进行统计,并对性别、孕产史、胎龄等19项因素与喂养耐受情况作回归分析,找出喂养不耐受的危险因素。结果:早产儿喂养不耐受发生率为47.8%;出生体重BW>2500g、2000g34周、32周相似文献   

An evaluation of enteral feeding practices in critically ill children

Background: Establishing and sustaining enteral feeding in critically ill children is challenging and has met with many problems. Aims and objectives: The aim of this study was to investigate (a) how actual calorie intake compared with estimated caloric requirements and (b) whether feeding guideline adherence resulted in improved nutritional intake. Design and methods: A prospective observational study was undertaken over 1 month in a tertiary referral paediatric intensive care unit (PICU) in the northwest of England. Results: Forty‐seven children were studied, with a wide range of diagnoses in a 1‐month period. Only 47% of the children had enteral feeds started within our 6 h post‐admission target. Over half (55%) of the children received less than half of their estimated calorie requirements, but if feeding guidelines were followed, this resulted in a significantly higher (p = 0·004) delivery of the child's estimated requirements. Conclusions: This study found that many children are not receiving adequate nutrition in PICU and that the use of feeding guidelines significantly improves calorie delivery in PICU patients. Relevance to clinical practice: This paper highlights the dearth of research related to enteral feeding in critically ill children. We found that the use of feeding guidelines improved calorie delivery and so units should be encouraged to develop their own guidelines based on the best evidence available.     

Managing infant feeding practices: the competing needs of bulimic mothers and their children

Aim. This paper seeks to explain how bulimic mothers accommodated infant feeding demands in conjunction with managing their disordered eating practices. Background. Eating disorders are chronic and disabling illnesses primarily affecting women. There are few qualitative studies describing bulimia in the context of motherhood. Design. The study employed an inductive qualitative approach. Methods. A purposive sample of childbearing women (n = 16), who self‐defined as living with an eating disorder, were recruited. Data were generated from one‐to‐one interviews; a thematic analysis identified key issues. Results. Participants were primarily responsible for ensuring child/ren’s socialisation processes, including modelling appropriate dietary behaviours and these demands often conflicted with their personal needs for food restraint. Pressures to participate in social activities with children were widely experienced as stressful especially when these events focused on food. Participants viewed early and repeated exposure to ‘healthy’ eating as protective against their children acquiring an eating disorder and in this respect commercial child‐care facilities provided alternative environments for children to explore food‐related activities. Conclusions. Participants employed a variety of strategies to ensure children’s exposure to normalising influences and socialising processes. Concerns about personal competencies with respect to food preparation and storage were articulated by all participants. Relevance to clinical practice. Professionals involved with providing care to mothers and their infants are well placed to support bulimic clients and to foster confidence in their mothering skills. Early and appropriate intervention is key to effecting positive changes in bulimic patterns, with potential benefits to women’s future health and well‐being and that of their children.     

辅食添加时间对婴儿生长发育影响的研究进展

综述了过早或过晚添加辅食对婴幼儿健康的影响及辅食添加的适宜时间,更好地指导儿童保健工作,提高合理喂养率,保障婴幼儿的健康成长。     

Preterm infants' behavioural indicators of oxygen decline during bottle feeding

BACKGROUND: During the time when preterm infants' oral feeding skills are developing they often experience physiological instability and need assistance from caregivers to maintain adequate oxygenation. Assisting infants to maintain optimal oxygenation during oral feeding requires an understanding of how they express and aim to self-regulate their oxygen status. AIM: The purpose of this study was to identify potential behavioural indicators of declining oxygenation during preterm infant early bottle-feeding. METHOD: The design was explorative. Data were collected from a secondary analysis of 20 videotapes of preterm infant bottle feedings which included concurrent oxygen saturation data. In this analysis infant behaviours and quality of breathing were coded and compared across three periods: high oxygen saturation, immediately preceding an oxygen desaturation event, and during an oxygen desaturation event. FINDINGS: Infants gave limited behavioural indicators of declining oxygenation. Immediately prior to a desaturation event, they had an increase in eye flutter and were typically sucking and apnoeic. During a desaturation event, they typically relaxed their arms/hands and stopped sucking. CONCLUSIONS: Reliance on preterm infant behavioural cues will be insufficient for detection of oxygen desaturation during oral feeding. Attention to changes in breath sounds and to the pattern of sucking are potentially important intervention strategies for the prevention of and appropriate response to oxygen decline during feeding. Sucking pauses may be a time when preterm infants aim to regulate their breathing pattern and thereby increase oxygenation. Interventions that focus on detection and minimization of apnoea during feeding, and which aim to protect infant sucking pauses, may reduce the number and severity of desaturation events preterm infants experience during bottle feeding.     

Impact of a standard feeding protocol to decrease time to reach full feeds and central line usage in babies’ less than 1500 g: A quality improvement initiative

BackgroundFeeding the preterm infant is a crucial task for the neonatologist. Early enteral feeding decreases the time to reach full feeding volume, as well as length of stay without increasing Necrotising Enterocolitis (NEC) or serious infections. In our neonatal unit, there was no standard feeding protocol that was being followed. There was a tendency to delay initial feeds with slower advancements, mainly due to fear of NEC. Hence, we decided to conduct this Quality Improvement initiative to standardise the enteral feeding guidelines, decrease time to reach full enteral feeds and secondarily to reduce the utilisation of central lines for infants with a birth weight less than 1.5 kg.MethodsThe Quality Improvement (QI) team targeted a goal to decrease time to achieve full enteral feeds from average 13 days to less than 10 days by May 2021 in Very low birth weight (VLBW) infants. All VLBW babies (1–1.5 kgs) irrespective of gestation age were included. A Standard Feeding Protocol was formulated, which was then implemented in the unit in September 2020 as part of the initiative. Time to reach full feeds and central line utilisation were used as the outcome measures. The study was planned in three phases and three major changes ideas were tested.Results36 newborns were enrolled retrospectively prior to the initiation of the standard feeding protocol and 48 neonates were enrolled after the feeding protocol was implemented in the NICU. The mean number of days to reach full feeds decreased from 13 days to 9 days and the average number of days with central line in situ decreased from 8.5 days to 5.7 days.ConclusionImplementation of a Standard feeding protocol promotes early initiation and rapid advancement of enteral feeding, thereby reducing the time to reach full feeds and decreasing central line usage.     

Effects of a feeding skills training programme on nursing assistants and dementia patients

Aims and objectives. The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty. Background. Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care. Design methods. A quasi‐experimental study was conducted. Two convenience‐chosen dementia‐specialized long‐term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty‐seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in‐service classes and one hour of hands‐on training, whereas the control group did not receive any training. Results. The treatment group had significantly more knowledge (F = 47·7, P < 0·001), more positive attitude (F = 15·75, P = 0·001) and better behaviours (t = 6·0, P < 0·001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2·7, P < 0·05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2·1, P < 0·05) than the control group. There was no significant difference on food intake between the two groups (t = 0·8, P = 0·49). Conclusion. This feeding skills training programme has been found to change nursing assistants’ knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients. Relevance to clinical practice. This study raises attention regarding on‐the‐job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.     

Litmus tests for verification of feeding tube location in infants: evaluation of their clinical use

Aims. To examine the clinical use of litmus paper tests for the assessment of aspirates in infants. Background. In connection with establishing a programme for home care of infants with requirement of tube feeding with parents as the infants’ carers, the need for a research‐based method for verification of feeding tube position was identified by nurses as a complement to other methods. In adult care the litmus paper test is commonly used when visual inspection is not sufficient for assessment of aspirates obtained from feeding tubes. Design. Observational study. Methods and material. Nurses performed litmus tests for verification of feeding tube location in a convenience sample of 60 infants born at a gestational age (GA) of 24–42 weeks. Presence/absence and volumes of aspirates were recorded as well as positive/negative litmus test reactions. Analyses on the association between test results and the infants’ GA and postmenstrual and postnatal age at the time of the tests were conducted. Results. Data were obtained from 2970 tube feeds. Aspirates were present on 1840 occasions (62%). A higher proportion of infants with absence of aspirates were born at a GA below 32 weeks. A positive reaction occurred in 97% of the tests in volumes between 0.01 and 22 ml. Birth at a GA below 32 weeks and respiratory problems were associated with negative tests. Conclusion. The high ratio of positive litmus reactions at all maturational levels supports the bedside use of analysis of pH in gastric aspirates for verification of feeding tube location. Relevance to clinical practice. Application of pH indicator paper is recommended as a complementary method for assessment of aspirates from feeding tubes.     

Feeding and speech difficulties in typical congenital Nemaline Myopathy

The present study is a retrospective case note review of children with a diagnosis of Nemaline Myopathy attending a tertiary neuromuscular centre. Nineteen patients with typical congenital Nemaline Myopathy are described in relation to their feeding and speech difficulties. Clinical data is presented on: genetic aetiology, severity and disease progression, survival, frequency of follow up, ambulation, faltering growth, frequency of respiratory infections, sleep hypoventilation, non-invasive ventilation (NIV), feeding difficulties, videofluoroscopy results, need for tube feeding (both naso-gastric tube and gastrostomy), gastro-oesophageal reflux and fundoplication. The clinical characteristics of the group include maintained ambulation, faltering growth, feeding difficulties, recurrent respiratory infections and respiratory failure. The majority of children required either gastrostomy or NIV or a combination of both. Faltering growth and gastrostomy preceded nocturnal hypoventilation and NIV in most cases. Gastrostomy had a positive effect on growth. Feeding difficulties, particularly those affecting safety of swallowing, present early in infancy and require a detailed multidisciplinary assessment. Videofluoroscopy demonstrated weak delayed swallowing with silent aspiration. Problems with chewing presented later in childhood. Oro-facial weakness showed a distinct and evolving pattern of open bite and malocclusion affecting oral movements for articulation, chewing and swallowing. Communication interventions are needed to manage dysarthria and weak voice.