title: A pilot study to assess the utility and perceived effectiveness of a tool for diagnosing feeding difficulties in children.
abstract: BACKGROUND
  Food dislikes in children may result in avoiding particular food/s with major sources of essential nutrients leading to increased risk of impaired growth or cognitive development and compromised immune function. It is necessary to identify conditions contributing to feeding difficulty and associated complications. An instrument was designed to assist diagnosis and management of children with feeding difficulties. The study was conducted to test utility of the "Identification and Management of Feeding Difficulties (IMFeD)" tool in Indian children.
  
  
  METHODS
  A prospective, cross-sectional study was conducted in Indian children between 2 and 10 years identified to have picky eating behaviour. After completion of both pro forma sections (parent and physician) of the IMFeD tool, the child's specific feeding difficulty was diagnosed and appropriate nutritional and/or behavioural counselling was provided. The subjects were followed at 30 and 60 days post-intervention.
  
  
  RESULTS
  According to 66% of paediatricians the IMFeD tool was very easy to use. Approximately 85% of paediatricians required ≤20 min to administer the tool, diagnose the feeding difficulty(ies) and provide specific counselling or behavioural management. More than 70% of parents were satisfied and willing to accept the use of the IMFeD tool. After 60 days, 65% of the parents were either less worried or not worried at all about the feeding behaviour of the child using recommendations made on the basis of the IMFeD tool. The toolkit helped parents to know what to do if their child had a feeding problem. A total of 90% of the parents expressed that the tool is useful for assessing feeding difficulties in children.
  
  
  CONCLUSIONS
  The IMFeD tool can be effectively used to identify feeding difficulties in Indian children. This toolkit also helps to offer nutritional and behavioural guidance as a part of the management.
authors.affiliation: Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Garg
authors.affiliation: Abbott Nutrition Research and Development, Abbott Laboratories, Columbus, OH USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Williams
authors.affiliation: Scientific and Medical Affairs, Abbott Nutrition International India, Mumbai, India.
authors.forename: Vinita
authors.initials: V
authors.lastname: Satyavrat
keywords: Child; Feeding and eating disorders of childhood; Tool use behavior