Cross-cultural adaptation and validation of Neonatal Eating Assessment Tool (NeoEAT)-Paladai/cup feeding in Tamil: a caregiver-reported assessment tool

Abstract

Background: Cup feeding is an alternative method to provide nutrition to infants exhibiting difficulties in breastfeeding. Paladai is a cup commonly used to feed milk to infants in several parts of India. Parental reports of infant feeding help address feeding concerns and establish successful oral feeding.

Method: This cross-sectional study was conducted in a quaternary care hospital in South India. The NeoEAT-Paladai/cup in Tamil was developed through a systematic process of cross-cultural adaptation and included 64 items. A total of 325 Tamil-speaking mothers of children younger than 7 months who were fed through the paladai exclusively or partially, along with breastfeeding, completed the NeoEAT-Paladai (Tamil).

Results: Factor analysis of the responses yielded five subscales with high internal consistency reliability across subscales (α=0.858 to 0.908) and the full scale (α=0.963). Test-retest reliability was high for the full scale (intraclass correlation=0.995). Infants with feeding concerns demonstrated significantly higher total and subscale scores than infants without feeding concerns (p<0.001).

Conclusion: The NeoEAT-Paladai (Tamil) allows clinicians and caregivers of Tamil-speaking populations to monitor the feeding behaviours of infants when being fed by paladai.

Keywords: Breastfeeding; Caregivers; Infant; Low and Middle Income Countries; Neonatology.