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Purpose: Evaluate the accuracy of an electromagnetic device (EMD) guided nasogastric tube (NGT) placement compared with standard confirmation methods. A secondary aim was to determine if EMD guided NGT placement would avert potential pulmonary misplacements of the tube., Design and Methods: Pediatric Intensive Care Unit (PICU) patients were enrolled if they had an NGT order during the study period of April 2014 through December 2016. Patients were included if they were one through 18 years of age. An EMD trained nurse inserted the NGT using EMD guidance. An insertion questionnaire, confirming if the nurse determined the NGT to be gastric per EMD, was completed immediately after NGT placement and before confirmation via either pH testing or radiographic imaging., Results: Forty-five patients were enrolled in the study. Nurses reported, based on EMD, that 86.7% (n = 39) of placements were gastric. Overall agreement between EMD guided tube placement and pH testing was 58% (n = 26). The marginal distribution was significantly different between the two methods (p = .0029). When compared to radiographic confirmation, sensitivity of the pH method was 32% (95% confidence interval [CI]: 17%-51%) compared with 85% (95% CI 69%-95%) for the EMD method., Conclusions: EMD guidance was superior to pH testing when compared with radiographic confirmation of nasogastric tube placement in children., Practice Implications: EMD guided NGT placement is a potentially viable method for confirming nasogastric tube placement in children when done by appropriately trained clinicians. More research on EMD guided NGT placement in children is needed before any practice recommendation can be made., (© 2021 Wiley Periodicals LLC.)

Purpose: The aim of this study was to compare the Mother-Infant/Toddler Feeding Scale (MITFS) and the Nursing Child Assessment Feeding Scale (NCAFS). Specific questions were as follows: (1) Are there differences between the results of the MITFS and the NCAFS tools in terms of rating infant feeding interactions? And (2) does one tool provide a more detailed, nuanced overview of the quality of feeding interactions than the other?, Design and Methods: This comparative descriptive study is a secondary analysis of a study evaluating a massage intervention for infants with symptoms of gastroesophageal reflux disease (GERD). A feeding observation for each dyad was scored using both the NCAFS and MITFS. Infants were 6-18 weeks of age., Results: There were moderate correlations (r = 0.3-0.8) between 11 of 20 possible NCAFS and MITFS mother-related subscales, and between 3 of 10 possible NCAFS and the MITFS infant-related subscales. A total of 19 dyads (83%) had one or more NCAFS subscale scores that were at least 1 standard deviation (SD) below normative scores, and 21 dyads (91%) had one or more MITFS subscale T-scores that deviated 1 SD from the normative T-scores. Agreement between the two instruments on scores deviating from the norm was 78%., Practice Implications: Both instruments discussed in this paper are standardized ways of assessing an infant feeding. Use of a standardized feeding tool is an objective way to evaluate feedings and can potentially identify specific areas of concern to guide an individualized intervention for a mother-infant dyad. Thus, nurses and other health professionals working with mothers and babies, whether in the hospital, pediatrician offices, or clinics would benefit from learning how to use a standardized feeding tool. Use of a feeding tool also provides the opportunity for nurses to understand the basis of important qualities of a feeding interaction, and a way for nurses who regularly feed infants to self-evaluate their feeding methods. This may minimize less than optimal interactions and allow for optimal support for infants during feedings by mothers and nurses., (© 2017 Wiley Periodicals, Inc.)

Purpose: The purpose of this review was to assess effectiveness of nonsurgical treatment on irritable behavior of infants with gastroesophageal reflux disease., Design and Methods: A systematic literature review was conducted., Results: Research targeted treatment for irritability in infants with gastroesophageal reflux disease. All interventions including placebo were similar in reducing irritability. Which specific intervention is best for which infant is not yet known. Minor adverse effects that could increase discomfort in infants were found with pharmacologic treatments., Practice Implications: Knowledge of the effects of treatment on irritability and regurgitation can assist the nurse to work with other care providers in deciding how best to treat an individual infant., (© 2011, Wiley Periodicals, Inc.)

Issues and Purpose: To investigate in what ways infant pain assessments differed between outpatient surgical recovery areas (OPSRA) and other clinical settings that included inpatient postsurgical recovery areas., Methods: Using a qualitative descriptive design, 8 nurse participants working in OPSRA and 7 nurse participants working in other clinical settings were interviewed., Results: The assessments of participants in the OPSRA differed from those of other participants and were confounded by effects of a short-acting anesthetic, lower expectations of pain, and several extraneous factors., Practice Implications: Recognizing infant pain in OPSRA is complex. Nurses working in OPSRA may need to assume leadership to address issues relating to accurate identification of infant pain and alleviating extraneous factors that may influence adequate treatment of pain.

Issues and Purpose: To describe the behavioral style and personality characteristics of young school-age children who were identified as colicky infants and the parents' perspective of any residual behaviors or effects., Design and Methods: A qualitative descriptive design with mothers of 12 children identified with colic as infants and 8 mothers of children who did not have colic., Results: Three themes of children who had colic: independence/self-reliance, activity, and emotional lability/intensity., Practice Implications: Children generally were perceived as normal and healthy. Residual feelings, parent-child interaction issues, and perceived or real persistent child characteristics may surface in families who experienced colic, especially during stressful periods.