Prospective data collection for feeding difficulties and nutrition
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INTRODUCTION: The Boston Children’s Hospital Growth and Nutrition Program is a multidisciplinary program focused on assisting babies and children under 6 years of age having problems with feeding and/or weight gain. New patients at the clinic are given questionnaires to complete which provide information on patient demographics, social history, feeding history, etc. The knowledge gained from these questionnaires help identify potential feeding disorders, identify risk factors or causes of malnutrition, and allow for tailored treatment in an individual patient. AIM: To describe the demographic, social, and clinical characteristics of a sample of patients referred to the Boston Children’s Hospital Growth and Nutrition Program while determining whether and how the Growth and Nutrition patient questionnaires should be revised and incorporate validated instruments to track patient feeding, stress, diet and body composition outcomes. METHODS: Examination of 239 patient records from 2015 and 2016 was performed. Data was collected and analyzed from questionnaires completed by guardians or caregivers of the patients, as well as the patients’ electronic medical records. Literature review was performed to assess existing feeding assessments as well as mobile intake tracker applications. A review of the mobile intake tracker applications was also performed. RESULTS: The results of analysis on the patient population at the Boston Children’s Hospital Growth and Nutrition Program showed that a majority of patients were White, Non-Hispanic, with private medical insurance and household income of over $60,000 (>60% of recorded patient population for each item). Similar patterns were observed for the rest of the items, with a few exceptions. The Neonatal Eating Assessment Tool (NeoEAT), Pediatric Eating Assessment Tool (Pedi-EAT), and the Child Oral and Motor Proficiency Scale (ChOMPS) feeding assessments had the most justification for use. The mobile applications Baby Connect and MyFitnessPal had the most desired features for clinical use. CONCLUSION: A few items on more specific portions of the questionnaires were deemed unnecessary for further use in the new patient questionnaires, such as having 4th, 5th, and 6th born choices for birth order of the patient (less than 4% of responses chose one of those answers or ‘Other’). The Neonatal Eating Assessment Tool (NeoEAT), Pediatric Eating Assessment Tool (Pedi-EAT), and the Child Oral and Motor Proficiency Scale (ChOMPS) feeding assessments are recommended for incorporation and use alongside the new patient questionnaires at the BCH GNP. The currently in use “Behavioral Pediatric Feeding Assessment Scale”, or “BPFAS”, is not recommended for continued use over the three assessments mentioned above. The mobile applications Baby Connect and MyFitnessPal are recommended for use in tracking of infant feedings and calories respectively, as the applications possessed the most number of desired features.