Feeding Disorders in Infants: Clinical Presentation, Assessment, and Intervention

Feeding is a foundational skill supporting infant growth, neurodevelopment, and bonding, yet neonatal feeding difficulties are common and often underestimated in clinical practice. Early challenges, particularly with breastfeeding, are associated with short- and long-term consequences for children and families. Hospitals play a critical role in early feeding support; however, assessment and management practices remain inconsistent, with limited evidence to guide standardisation. This thesis examines neonatal and early feeding difficulties from multiple perspectives, integrating clinical assessment tools, parental and professional experiences, and infant outcomes over time. Chapter 2 presents a systematic review of oral feeding assessment tools used in hospitals, identifying substantial variability, limited validation, and a lack of consensus on best practice. Chapter 3 explores mothers’ experiences of breastfeeding support during hospitalisation, highlighting inconsistent guidance and emotional strain. Chapter 4 examines healthcare professionals’ perspectives, revealing challenges related to training, workload, and interprofessional consistency. Longer-term feeding outcomes are explored in subsequent chapters. Chapter 5 analyses maternal reports of early feeding challenges persisting into early childhood. Chapter 6 focuses on infants diagnosed with tongue-tie, reporting significant breastfeeding difficulties and mixed outcomes following intervention. Chapter 7 presents a prospective evaluation of infants identified with feeding difficulties during hospitalisation, demonstrating diverse feeding trajectories across the first year. Together, these findings highlight the importance of consistent, family-centred assessment, improved professional training, and structured post-discharge monitoring to support at-risk infants and families and inform clinical practice and hospital policy.