Elsevier

The Journal of Pediatrics

Volume 223, August 2020, Pages 81-86.e2
The Journal of Pediatrics

Original Article
Psychometric Properties of the Infant and Child Feeding Questionnaire

https://doi.org/10.1016/j.jpeds.2020.04.040Get rights and content

Objectives

To report the updated psychometric properties of a child feeding questionnaire and to report the psychometric properties of a screening tool developed from this questionnaire. A secondary objective was to consider if items from a behavior checklist embedded within the Infant and Child Feeding Questionnaire may be useful in making referrals for feeding problems.

Study design

Caregivers of children younger than the age of 4 years with pediatric feeding disorders (as defined by International Classification of Diseases, Ninth Revision, criteria) were recruited from 2 outpatient clinics. A comparison group with no feeding problems was recruited during well child checks from community clinics. Caregivers completed a demographic questionnaire and a child feeding questionnaire. Exploratory and confirmatory analyses identified questionnaire items that differentiated groups. Remaining items were summed and area under the curve, sensitivity, and specificity values were calculated to describe the resulting screening tool. ORs of behaviors from the embedded behavior checklist were calculated to determine whether specific behaviors could be useful for referrals.

Results

Responses of 989 caregivers (pediatric feeding disorders, n = 331; no feeding problems, n = 650) were obtained. Six questions of the child feeding questionnaire differentiated groups accounting for 60% of variance. Sensitivity (73%) and specificity (93%) were greater when any 2 or more of these 6 items was endorsed. Three items of the embedded feeding behaviors checklist show promise for referrals to specific provider disciplines.

Conclusions

A pediatric feeding disorders screening tool consisting of 6 questions from a child feeding questionnaire is psychometrically sound. Use of this tool may expedite referrals for treatment. Further study of the embedded behavior checklist may be useful for clinical referrals.

Section snippets

Methods

This study was approved by the institutional review boards (IRBs) at each of the 2 participating institutions (University of Utah IRB protocol #00074797 and Milwaukee Children's Hospital IRB protocol #442506-5). Participants with pediatric feeding disorders and no feeding problems were recruited equally from university hospital–based outpatient clinics at the 2 participating institutions. Inclusion criteria focused on male and female children (age: birth to 4-years) who met International

Results

Responses of 989 caregivers (pediatric feeding disorders n = 331; no feeding problems n = 650) were obtained. Demographic comparisons are shown in Table II. Significant difference were found across the pediatric feeding disorders and no feeding problems groups (Table II) in terms of education (χ2[7, N = 971] = 40.13, P < .01, phi = .20), marital status (χ2[5, N = 971] = 17.33, P < .01, phi = .20), income (χ2[7, N = 971] = 39.54, P < .001, phi = .2), and child age (t[984] = 10.503, P = <.001, d

Discussion

In the US, pediatric feeding disorders affect 478 000 to 8.7 million children nationwide3, 4, 5 and account for 3% of pediatric hospital admissions13 secondary to sequala of the pediatric feeding disorders (acute malnutrition, dehydration, etc).14 Although PCPs are best positioned to identify children with pediatric feeding disorders, they lack tools to reliably distinguish these from transient, minor feeding concerns.

Our results demonstrate that the questionnaire items of the ICFQ are

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Supported by Feeding Matters, which provided financial support for research assistant data collection. The authors declare no conflicts of interest.

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