Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 13;9(1):e003403.
doi: 10.1136/bmjpo-2025-003403.

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

Gopalakrishnan Jayapradha  1 , Prakash Amboiram  2 , Sanjanaa Anand  1 , Deekshitha Akula  1 , Britt Frisk Pados  3 , Lakshmi Venkatesh  4
Affiliations

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

Gopalakrishnan Jayapradha et al. BMJ Paediatr Open. .

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.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Malhotra N, Vishwambaran L, Sundaram KR, et al. A controlled trial of alternative methods of oral feeding in neonates. Early Hum Dev. 1999;54:29–38. doi: 10.1016/s0378-3782(98)00082-6. - DOI - PubMed
    1. Weinberg F. Infant feeding through the ages. Can Fam Physician . 1993;39:2016–20. - PMC - PubMed
    1. Lang S, Lawrence CJ, Orme RL. Cup feeding: an alternative method of infant feeding. Arch Dis Child. 1994;71:365–9. doi: 10.1136/adc.71.4.365. - DOI - PMC - PubMed
    1. McKinney CM, Glass RP, Coffey P, et al. Feeding Neonates by Cup: A Systematic Review of the Literature. Matern Child Health J. 2016;20:1620–33. doi: 10.1007/s10995-016-1961-9. - DOI - PMC - PubMed
    1. Dalal SS, Mishra S, Agarwal R, et al. Feeding behaviour and performance of preterm neonates on Paladai feeding. Acta Paediatr. 2013;102:e147–52. doi: 10.1111/apa.12148. - DOI - PubMed

Publication types