Fuls Nichole, Krüger Esedra, van der Linde Jeannie
Department of Speech-Language Pathology and Audiology, Faculty of Humanities, University of Pretoria, Pretoria, South Africa.
J Paediatr Child Health. 2020 Jul;56(7):1083-1089. doi: 10.1111/jpc.14823. Epub 2020 Feb 19.
To describe feeding characteristics (such as breast feeding and complementary feeding) and determine the nature of feeding difficulties of infants in a primary health-care clinic (PHC) in South Africa.
A total of 200 infants aged 6-12 months (mean = 8.54, standard deviation = 2.18) received a feeding screening by a speech-language therapist at a PHC in a semi-urban area using the Montreal Children's Hospital-Feeding Scale (MCH-FS). Children who failed screening underwent further clinical feeding evaluation using the Schedule of Oral Motor Assessment.
The sample consisted of 200 participants, and most participants (n = 174; 87%) received breastfeeding, irrespective of their mothers' human immunodeficiency virus status. The longer the breastfeeding period, the less likely parents were to show concern about infants' feeding (P = 0.035). Complementary feeding was introduced between 6 and 8 months (n = 122; 82%). The MCH-FS identified 13 participants with feeding difficulties (6.5%), of which 11 were diagnosed with oral motor dysfunction (OMD) using the Schedule of Oral Motor Assessment. The 6.5% (n = 13) that failed had mild (n = 8; 61.5%), moderate (n = 2; 15.4%) and severe (n = 3; 23.1%) feeding difficulties, as reported by care givers using the MCH-FS. The MCH-FS showed that distraction during meals/following infants (n = 42; 21%); food refusal (n = 31; 15.5%); care giver unease about feeding (n = 29; 14.5%); and problems with vomiting, gagging or spitting (n = 28; 14%) were characteristics of feeding in this sample. Participants in the age groups 6 (n = 3; 27.3%) and 10 months (n = 3; 27.3%) were prone to OMD.
This study is the first of its kind to describe the feeding characteristics of a group of infants during the transitional feeding stage in late infancy in South Africa. Important findings were the existence of OMD in 11 infants and feeding difficulties during transitional feeding in 13 infants. The study's findings may be used as a starting point for larger-scale studies in a similar setting, investigating the development of future care giver education and health-care professional training programmes regarding transitional feeding. Research endeavours by speech-language therapists need to prioritise late infancy and transitional feeding in order to prevent possible difficulties arising from sub-optimal care giver feeding practices. The study may be valuable to all health-care providers in PHC.
描述南非一家初级卫生保健诊所（PHC）中婴儿的喂养特征（如母乳喂养和辅食添加），并确定喂养困难的性质。
共有200名6至12个月大的婴儿（平均年龄=8.54岁，标准差=2.18）在半城市地区的一家初级卫生保健诊所接受了语言治疗师使用蒙特利尔儿童医院喂养量表（MCH-FS）进行的喂养筛查。筛查未通过的儿童使用口腔运动评估表进行进一步的临床喂养评估。
样本包括200名参与者，大多数参与者（n=174；87%）接受母乳喂养，无论其母亲的人类免疫缺陷病毒状态如何。母乳喂养时间越长，父母对婴儿喂养表现出担忧的可能性就越小（P=0.035）。辅食添加在6至8个月之间开始（n=122；82%）。MCH-FS识别出13名有喂养困难的参与者（6.5%），其中11名使用口腔运动评估表被诊断为口腔运动功能障碍（OMD）。根据护理人员使用MCH-FS报告，筛查未通过的6.5%（n=13）有轻度（n=8；61.5%）、中度（n=2；15.4%）和重度（n=3；23.1%）喂养困难。MCH-FS显示，进餐时注意力分散/追赶婴儿（n=42；21%）；拒食（n=31；15.5%）；护理人员对喂养感到不安（n=29；14.5%）；以及呕吐、作呕或吐口水问题（n=28；14%）是该样本中的喂养特征。6个月（n=3；27.3%）和10个月（n=3；27.3%）年龄组的参与者易患OMD。
本研究首次描述了南非一组婴儿在婴儿晚期过渡喂养阶段的喂养特征。重要发现是11名婴儿存在OMD，13名婴儿在过渡喂养期间存在喂养困难。该研究结果可作为在类似环境中进行大规模研究的起点，调查未来护理人员教育和医疗保健专业人员过渡喂养培训计划的发展情况。语言治疗师的研究工作需要优先关注婴儿晚期和过渡喂养，以防止因护理人员喂养方式欠佳而可能产生的困难。该研究对初级卫生保健中的所有医疗保健提供者可能都有价值。
