Is there an advantage for preterm infants to feed orally in an upright or sidelying position?

Area of Science:

• Neonatal care
• Pediatric nutrition
• Infant feeding practices

Background:

• Nursing staff and feeding therapists have advocated for upright and sidelying bottle feeding positions for preterm infants, considering them optimal.
• Previous recommendations suggested these positions enhance feeding efficiency and safety for vulnerable infants.

Purpose of the Study:

• To investigate the efficacy of upright and sidelying bottle feeding positions compared to a semi-reclined position for very low birth weight infants.
• To determine if specific feeding positions accelerate the achievement of independent oral feeding and improve oral feeding skills in preterm infants.

Main Methods:

• A randomized controlled trial involving very low birth weight infants.
• Infants were assigned to three feeding position groups: semi-reclined (control), upright, or side-lying.
• Outcomes measured included days to independent oral feeding and oral feeding skill maturation.

Main Results:

• Infants in the upright and sidelying groups achieved independent oral feeding in the same number of days as those in the semi-reclined (control) group.
• No significant differences were observed in the maturation of oral feeding skills across the three feeding position groups.
• The study found no benefit of upright or sidelying positions over the customary semi-reclined position for preterm infant feeding outcomes.

Conclusions:

• The commonly promoted upright and sidelying bottle feeding positions do not offer advantages over the semi-reclined position for preterm infants regarding the time to independent oral feeding or skill development.
• Current feeding position recommendations for preterm infants may require re-evaluation based on this evidence.
• Further research could explore other factors influencing oral feeding in preterm infants.