RESUMEN
PURPOSE: Nutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool. METHODS: Retrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool. RESULTS: There was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital. CONCLUSION: The moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.
RESUMEN
The incidence of infantile colic is between 5-20%. It occurs equally in breast- and bottle-fed infants, and in both sexes. The aetiology is unknown. The elimination of cow's milk protein and using extensively hydrolysed protein formula have been shown to be effective treatments for infantile colic. Partially hydrolysed milk has also been shown to be helpful and can be a useful option in the community when a cow's milk allergy is not considered to be an underlining cause of the colic. If symptoms persist the situation should be reassessed, as further investigations and treatment may be necessary. Certain behavioural interventions, such as reassurance, making changes to the parents' responsiveness to the infant, using motion/sound to calm the infant and reducing stimuli to the infant have also been shown to be effective treatments for infantile colic. There is some evidence to suggest that the use of prebiotic oligosaccharides, to restore normal healthy gut flora, can be beneficial. Soya milk is not recommended as a treatment.
