{
  "abstract": "Introduction Our objective was to describe the population of infants <7 days of age admitted to the acute general paediatric services at Alder Hey Children’s Hospital and ascertain the proportion with feeding difficulties amenable to community-based support.Methods Sequential retrospective audits of all infants <7 days of age admitted to acute paediatrics at Alder Hey Children’s Hospital, Liverpool, England, from March to September 2019 (pre-COVID-19) and March to September 2020 (during COVID-19). All the infants were born and discharged from maternity units in Merseyside, Northwest England. Anonymised data were extracted from the electronic clinical records by three members of the clinical team.Results Pre-COVID-19, 38.6% (93) of the 241 admissions to acute general paediatric services had feeding difficulties. 31.2% (29) presented solely with feeding difficulties and 31.2% (29) were exclusively breastfed. However, during COVID-19, although there were fewer admissions (104), more than half (51%, 54) had feeding difficulties and for 54% (29), this was the only reason for admission. Over half (53.7%, 29) were exclusively breastfed.Conclusion Our audits showed that at least a third of infants <7 days of age admitted with feeding difficulties did not have any other features of severe illness. These admissions unnecessarily expose infants to hospital-acquired infections while disrupting the opportunity for families to build close and loving relationships that enhance the establishment of breastfeeding. Co-designing infant feeding strategies with the mothers and stakeholders will be a crucial next step to enhance infant feeding support, particularly in impoverished communities in the region.",
  "authors": [
    {
      "affiliations": [
        "General Paediatrics, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Kalvin Lee"
    },
    {
      "affiliations": [
        "Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Thomas Frederick Dunne"
    },
    {
      "affiliations": [
        "Department of General Paediatrics, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Mary Masoud"
    },
    {
      "affiliations": [
        "Department of General Paediatrics, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK",
        "Department of Paediatrics, Betsi Cadwaladr University Health Board, Bangor, UK"
      ],
      "name": "Hayley Gleig"
    },
    {
      "affiliations": [
        "Department of General Paediatrics, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Heidi Stott"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK",
        "Centre of Excellence in Women and Child Health, Aga Khan Education Board Kenya, Nairobi, Kenya"
      ],
      "name": "Helen Nabwera"
    },
    {
      "affiliations": [
        "Department of General Paediatrics, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Halina Kamarova"
    }
  ],
  "title": "Early neonatal admissions with feeding difficulties to acute paediatric services at a tertiary paediatric hospital in England: sequential audits pre-COVID-19 and during the COVID-19 pandemic",
  "uid": "1a8135fc-c26f-5e63-b147-6797632c6c7e"
}