Efficacy of semielevated side-lying positioning during bottle-feeding of very preterm infants: a pilot study

Area of Science:

• Neonatology
• Pediatric Gastroenterology
• Respiratory Physiology

Background:

• Very preterm infants (≤30 weeks gestational age) often experience impaired lung function, complicating oral feeding.
• Feeding difficulties in very preterm infants can be exacerbated by respiratory challenges.
• The semielevated side-lying (ESL) position is a potential feeding strategy to support respiratory function.

Purpose of the Study:

• To evaluate the efficacy of the semielevated side-lying (ESL) position versus the semielevated supine (ESU) position.
• To assess the impact of feeding position on physiological stability and feeding performance in bottle-fed very preterm infants.

Main Methods:

• A within-subject crossover design was employed with 6 very preterm infants.
• Infants were bottle-fed in both ESL and ESU positions on the same day, in random order.
• Physiological stability (heart rate, oxygen saturation, respiratory characteristics) and feeding performance were measured.

Main Results:

• Infants in the ESL position showed significantly less heart rate variability and fewer heart rate drops.
• Respiratory rate remained closer to baseline, with shorter and more regular breath intervals in the ESL position.
• Apneic events related to feeding were briefer in the ESL position; no significant differences in oxygen saturation or feeding performance were observed.

Conclusions:

• The ESL position may enhance physiological stability in very preterm infants during oral feeding.
• This position appears to support better regulation of breathing, mitigating cardiorespiratory instability.
• Further research can explore optimizing feeding positions for vulnerable preterm populations.