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Abstract
Aims, Objectives and Background In 2020 limited evidence suggested increased emergency department (ED) attendances for infants in England, associated with feeding problems. We examined the frequency and distribution of infant feeding-related attendances (IFA) at EDs before and during the SARS-CoV2 pandemic.
Method and Design All attendances at 48 major EDs (England) in two 50-week periods before and during the COVID-19 pandemic: period 1, 2 April 2019 to 10 March 2020 and period 2, 1 April 2020 to 10 March 2021. Anonymised datasets were obtained from the National Commissioning Data Repository across all age groups, with an infant defined as <1year.
We estimated the change in frequency of ED presentations by age group and diagnosis before and after the SARS-CoV2 pandemic began in England. We compared changes in the frequency of attendances of IFP by infant age, sex, ethnicity, deprivation, rurality, arrival mode, arrival time, acuity, mother’s age, gravidity and mental health, birth length of stay, attendance duration and disposal (admission or discharge). IFA was classified as feeding problems, neonatal jaundice and gastro-oesophageal reflux.
Results and Conclusion Whilst total ED attendances fell by 16.7% (95% CI -16.8% to -16.6%), infant attendances increased for feeding problems (+7.5% 95% CI 2.3% to 13.0%), neonatal jaundice (+12.8%, 95% CI 3.3% to 23.3%) and gastro-oesophageal reflux (+9.7%, 95% CI 4.4% to 15.2%). These increases were more pronounced amongst first babies (+22.4%, 95% CI 13.1% to 32.5%) and brief hospital stay after birth (0–1 days, +20.1%, 95% CI 14.8% to 25.7%). Our analysis suggests many of these attendances were low acuity. Taken together, IFA presentations (figure 1) increased by 8.9% (95% CI 5.4% to 12.5%) in 2020–21.
ED attendances reduced dramatically and systematically with the COVID-19 pandemic, but infant feeding-related attendances increased. This implies growth in the unmet needs of infants and identifies future target groups for health policy.