Nurses' Techniques for Bottle-Feeding of Infants with Feeding Difficulties: A Qualitative Descriptive Study

Background/Objectives: This study identified bottle-feeding techniques for infants with feeding difficulties. Methods: Between December 2021 and April 2022, a survey was distributed to nurses with at least 5 years of experience in caring for infants at 1109 hospitals in Japan. The questionnaire included open-ended questions regarding preparation before bottle-feeding, methods of nipple insertion, methods of assisting with sucking, and criteria for continuing bottle-feeding. The responses were classified according to semantic similarity. Results: In total, 514 valid responses were received. The respondents had an average of 19.16 years of experience as a nurse or midwife. The most frequently used nipples for infants with feeding difficulties were the Combi Breastfeeding Model, Pigeon Weak Sucking Nipple, and Bean Stalk Nipple. Preparation before bottle-feeding consisted of six categories, including determining the timing of feeding and stimulation to promote wakeup. Nipple insertion methods consisted of four categories, such as assisted opening of the mouth, nipple insertion, and nipple insertion depth. Methods of assisting with sucking were divided into four categories, including encouraging sucking ability from around the mouth and matching the infant's sucking pace. The criteria for continuing bottle-feeding spanned three categories, including willingness to suck and ensuring necessary nutrition. Conclusions: The variety of survey responses describes the current state of bottle-feeding technologies. A combination of several techniques indicated that feeding strategies may lead to effective and appropriate feeding. The nurses continued feeding based on an assessment of the infant's acceptance. Future studies regarding bottle-feeding techniques must consider the individuality of each infant.