An interdisciplinary feeding team approach for preterm, high-risk infants and children

Poor oral feeding abilities in high-risk infants and children require interdisciplinary assessment and treatment in relation to nutrition, growth, oral feeding skills, behavioural interactions, and family coping. This paper describes the Perinatal Feeding Team's experiences, the format of our assessments, and the frequency of interventions recommended for 33 patients referred over 18 months. The most frequent reasons for assessment were suspected oral sensorimotor dysfunction/disorganization, decreased growth velocity, and feeding skills delay (each 18.3%); aversive reactions to feeding (14%) and significant parental stress around feedings (13.3%). Preassessment tools facilitated identification of relevant feeding problems. The dietitian, occupational therapist, psychologist, and parents played specific roles in providing a comprehensive feeding assessment. Interventions most frequently recommended were nutrition counselling (97%), food texture and feeding skill progression (90.9%), and normalizing sensorimotor function (84.8%). These findings led to the development of the Oral Eating Readiness Assessment List (ORAL(C)). Coordinated care plans are individualized and prioritized with parents. Our collaborative approach to multifaceted feeding difficulties in a follow-up clinic for preterm, high-risk children continues to evolve as we learn more about the needs of these children and their families.