Document Detail

A comparison of the safety of cupfeedings and bottlefeedings in premature infants whose mothers intend to breastfeed.
MedLine Citation:
PMID:  11593367     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare the safety of cupfeeding, an alternative feeding method, to bottlefeeding, the current standard of artificial feeding in the United States, in preterm infants whose mothers intend to breastfeed. STUDY DESIGN: In a prospective, randomized crossover study, 56 infants <or=34 weeks at birth, whose mothers indicated a desire to breastfeed, were studied. Skin-to-skin care and attempts at breast were encouraged frequently when babies were physiologically stable. When infants were >or=34 weeks' corrected gestational age, the order of the first two non-breast oral feedings was randomized by coin toss to one cupfeeding and one bottlefeeding. Trained Neonatal Intensive Care Unit nurses provided the feedings. Heart rate, respiratory rate, and oxygen saturation were recorded at 1-minute intervals for 10 minutes before and during the feeding. Volume taken, time required to complete the feed, and any apnea, bradycardia, choking, or spitting episodes were recorded. RESULTS: Heart rate (p<0.0001) and respiratory rate (p<0.0001) increased and oxygen saturation decreased (p=0.0002) during both cup and bottlefeedings compared to pre-feeding baselines. The amount of change in these three parameters from baseline to feeding period was similar for both feeding methods. The fraction of O(2) saturation <90% during baseline compared to the study period was different between these two feeding methods (p=0.02). There was a 10-fold increase in desaturations <90% during bottlefeeds compared to no change during cupfeeds. When comparing cupfeeding periods to bottlefeeding periods, heart rates were higher (p=0.009) and oxygen saturations lower (p=0.02) during bottlefeeds. There were no differences between methods in respiratory rate, choking, spitting or apnea, and bradycardia. Volumes taken were lower (p=0.001) and duration of feeds longer (p=0.002) during cupfeedings. CONCLUSION: During cupfeedings, premature infants are more physiologically stable, with lower heart rates, higher oxygen saturations, and less desaturations, than during bottlefeedings. However, cupfed infants took less volume, over more time, than bottlefed for these initial feedings. Based on better physiologic stability and no difference in untoward effects, cupfeeding is at least as safe, if not safer, than bottlefeeding in this population. This study supports the use of cupfeeding as a safe alternative feeding method for premature infants learning to breastfeed.
K A Marinelli; G S Burke; V L Dodd
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  21     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-10-10     Completed Date:  2001-11-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  350-5     Citation Subset:  IM    
Division of Neonatology, Connecticut Children's Medical Center, Hartford, CT 06106, USA.
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MeSH Terms
Bottle Feeding*
Breast Feeding
Cross-Over Studies
Feeding Methods*
Heart Rate
Infant, Newborn
Infant, Premature* / physiology
Oxygen / blood
Prospective Studies
Reg. No./Substance:
Comment In:
J Perinatol. 2001 Sep;21(6):349   [PMID:  11593366 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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