1. Thoyre, Suzanne M. PhD, RN, FAAN
  2. Pados, Britt Frisk PhD, RN, NNP-BC
  3. Shaker, Catherine S. MS/CCC-SLP, BCS-S
  4. Fuller, Kristy OTR/L
  5. Park, Jinhee PhD, RN


Background: Supporting infants as they develop feeding skills is an essential component of neonatal and pediatric care. Selecting appropriate and supportive interventions begins with a thorough assessment of the infant's skills. The Early Feeding Skills (EFS) tool is a clinician-reported instrument developed to assess the emergence of early feeding skills and identify domains in need of intervention.


Purpose: The purpose of this study was to identify the factor structure of the EFS and test its psychometric properties, including internal consistency reliability and construct validity.


Methods: EFS-trained interprofessional clinicians in 3 settings scored 142 feeding observations of infants 33 to 50 weeks' postmenstrual age. Redundant and rarely endorsed items were removed. Factor analysis methods clustered items into subscales. Construct validity was examined through the association of the EFS with (1) concurrently scored Infant-Driven Feeding Scale-Quality (IDFS-Q), (2) infant birth risk (gestational age), and (3) maturity (postmenstrual age).


Results: Principal components analysis with varimax rotation supported a 5-factor structure. The total EFS demonstrated good internal consistency reliability (Cronbach [alpha]= 0.81). The total EFS score had construct validity with the IDFS-Q (r =-0.73; P < .01), and with gestational age of a subsample of premature infants (r = 0.22; P < .05).


Implications for Practice: As a valid and reliable tool, the EFS can assist the interprofessional feeding team to organize feeding assessment and plan care.


Implications for Research: The strong psychometric properties of the EFS support its use in future research.