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Published on: February 5, 2019
A randomised trial of two techniques for bottle feeding preterm infants
Jennifer A Dawson1, Leanne R Myers, Anita Moorhead
1Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia. jennifer.dawson@thewomens.org.au
Insights
Bottle feeding preterm infants in a cradle hold or side-lying position showed similar physiological stability. Both positions are suitable for transitioning preterm infants from tube to oral feeds.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Infant physiology
Background:
- Preterm infants transition to oral feeding around 34 weeks postmenstrual age.
- Assessing physiological stability during this transition is crucial.
- Bottle feeding positions may impact infant stability.
Purpose of the Study:
- To compare physiological stability in preterm infants during bottle feeding in two positions: cradle hold versus side lying.
- To evaluate oxygen saturation and heart rate during and after feeding in different positions.
Main Methods:
- Randomised crossover trial involving preterm infants (≥34 weeks postmenstrual age).
- Oxygen saturation (SpO₂) and heart rate (HR) monitored before, during, and after feeds.
- Paired t-tests and chi-squared tests used for data comparison.
Main Results:
- No significant differences in mean SpO₂ or heart rate between cradle hold and side-lying positions.
- A trend suggested infants consumed a smaller proportion of feeds in the cradle hold position (82% vs. 87%).
- No significant difference in the number of bradycardia episodes (HR <100 bpm).
Conclusions:
- Both cradle hold and side-lying positions appear appropriate for bottle feeding preterm infants.
- These positions support physiological stability during the transition from tube to sucking feeds.
Aim:
Preterm infants begin the transition from gastric tube feeds to sucking feeds around 34 weeks' postmenstrual age. We compared physiological stability in two bottle feeding positions, cradle hold versus side lying in preterm infants.
Methods:
Randomised crossover trial of infants <34 weeks' gestation at birth, ≥34 weeks' postmenstrual age at study and receiving at least two sucking feeds/day. Two feeds were studied on successive days. A pulse oximeter measured oxygen saturation (SpO₂) and heart rate (HR) before, during and 30 min after feeds. Continuous data were compared using paired t-tests and proportions using chi squared.
Results:
Twenty-five study infants were mean (standard deviation (SD)) 37 (2.4) weeks' post-menstrual age and 2740 (589) g at study. There was little difference in mean (SD) SpO₂ during feeds between the cradle-hold and side-lying position 94 (6) % versus 95 (6) %, respectively (P = 0.55, confidence interval (CI) -1.4, 5.4). During feeds, 17/25 (68%) experienced a period of SpO₂ <80% in the cradle-hold position compared with 14/25 (56) % in the side-lying position (P = 0.26, CI 0.68, 4.10). There were no significant differences in the mean HR or number of episodes of bradycardia HR <100 bpm. There was a trend towards infants consuming a smaller mean (SD) proportion of their feed in the cradle-hold position compared with the side-lying position, 82 (25) % versus 87 (20) % (P = 0.08, CI -0.64, 10.00).
Conclusions:
There was little difference in infants' physiological stability between the two bottle feeding positions. Both methods may be appropriate for the transition from gastric tube to sucking feeds in preterm infants.
