Factors associated with feeding problems in bottle-fed preterm infants: A descriptive cross-sectional study

The feeding problems of preterm infants often persist after neonatal intensive care unit discharge. Further evidence on the feeding problems preterm infants experience after hospital discharge is needed to better serve this vulnerable population. This study aimed to identify infant-related factors associated with bottle-feeding problems in preterm infants before the age of 7 months.

This descriptive and cross-sectional study included 338 mothers of preterm infants younger than 7 months of corrected age between April 2023 and April 2024. Mothers completed a survey that included infant and mother information form and Turkish version of the NeoEAT-Bottle-feeding assessment tool.

Very and moderately preterm infants exhibited more problematic feeding symptoms according to NeoEAT-Bottle-feeding total scale and all subscale scores compared with late preterm infants (P < 0.05). Gestational age at birth was negatively correlated with NeoEAT-Bottle-feeding total scores (P = 0.001). Additionally, preterm infants with a diagnosed feeding problem had higher NeoEAT-Bottle-feeding total and subscale scores than those without (P < 0.01). In the multivariate regression analysis, very preterm status and presence of gastroesophageal reflux were predictors of higher NeoEAT-Bottle-feeding total and all subscale scores (P < 0.01), and moderately preterm status was associated with higher NeoEAT-Bottle-feeding total (P = 0.036) and infant regulation subscale scores (P = 0.001).

Very preterm and moderate preterm birth, gastroesophageal reflux, and diagnosed feeding disorders were associated with problematic feeding. Identifying preterm infants who have difficulty with bottle feeding can guide primary care interventions or referral to specialists to achieve more favorable long-term outcomes.