Analysis of the Scope of Neonatal Feeding Assessment Methods and Tools in Hospitals: A Systematic Review

Background The lack of guidelines for early feeding assessment has a significant impact on infants and mothers, as incomplete or inadequate feeding evaluations can result in incorrect diagnoses, making feeding difficulties unmanageable. Objective The aim of this systematic review was to analyze the literature on what tools are currently used, how comprehensive and person-centred they are, and which disciplines are currently involved with neonatal feeding assessment during hospital stay after birth. Methodology A systematic review was proposed to analyze all articles published between 2012 and June 2022. Databases included PubMed, MedLine, and Web of Science. Included articles assessed feeding difficulties in infants (12 months or younger) during hospital stays after birth in maternity hospitals or neonatal intensive care units (NICUs). Articles in languages other than the primary languages of the authors (i.e., English and Portuguese), review articles, book chapters, commentaries, and letters to the editor were excluded from the present research. The initial search yielded a total of 698 articles for review, with an additional 10 articles found through the gray literature search. Thirty-three articles were removed after deduplication, and the remaining studies (675) were included for title and abstract screening. Results Two authors independently conducted 84 full-text reviews, and a total of 40 articles were included in the present study. Thirteen observational assessment tools, five clinical bedside assessments, five questionnaires or interview methods, four instrumental assessments, and four other types of assessment tools or methods were identified. Conclusion The variability of feeding assessment methods and tools for infants indicates a lack of standardization in breastfeeding assessment. The results of this research suggest that all described feeding or breastfeeding assessment tools are not comprehensive or person-centered, as they do not include all major aspects that can impact breastfeeding. Therefore, a consistent approach to breastfeeding assessment in hospitals is recommended to increase the incidence of breastfeeding success in the first 6 months of life. Finally, healthcare professionals who would like to promote, assess, and treat breastfeeding difficulties should pursue additional training or credentialing in breastfeeding and maternal-infant health.