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Cue-based feeding and growth in preterm infants: a two-year follow-up study
Iris Morag1, Dina Kogan1, Eden Weinberg2
1Shamir Medical Center, Affiliated with the Gray Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Cue-based feeding (CBF) in preterm infants led to earlier discharge and better parent-infant feeding interactions. This approach supports normal growth and may optimize infant outcomes when combined with nutritional monitoring.
Area of Science:
- Neonatal nutrition
- Pediatric feeding
- Infant growth and development
Background:
- Preterm infants often face feeding challenges.
- Traditional feeding (TF) methods may not always optimize infant outcomes.
- Cue-based feeding (CBF) offers a responsive approach to infant feeding.
Purpose of the Study:
- To compare growth trajectories and feeding characteristics up to two years of age between preterm infants fed using traditional feeding (TF) and cue-based feeding (CBF).
Main Methods:
- Retrospective cohort study of preterm infants (27⁰/₇-33⁶/₇ weeks' gestation).
- Comparison of feeding epochs: TF vs. CBF.
- Assessment of anthropometric indices and feeding characteristics using the Montreal Children's Hospital Feeding Scale (MCHFS) at two years.
Main Results:
- CBF was associated with shorter hospital stay and earlier discharge.
- Weight and head circumference Z-scores at discharge were similar between groups.
- While both groups showed growth declines, the TF group had consistently lower weight and length-for-age Z-scores.
- Coercive feeding behaviors were more prevalent in the TF group at two years.
Conclusions:
- Cue-based feeding (CBF) is linked to earlier discharge and more adaptive parent-infant feeding interactions in preterm infants.
- CBF supports normal growth trajectories.
- Integrating responsive feeding with nutritional monitoring may enhance both physical and relational outcomes for preterm infants.
Aim:
To study the association between cue-based feeding (CBF) and growth trajectories and feeding characteristics up to two years of age.
Methods:
A retrospective cohort study of preterm infants born at 27⁰/₇-33⁶/₇ weeks' gestation across two feeding epochs [traditional feeding (TF) vs. CBF]. Anthropometric indices were assessed at discharge and during routine follow-up. Feeding characteristics at two years were assessed using the Montreal Children's Hospital Feeding Scale (MCHFS).
Results:
The cohort included 115 infants (TF n = 58; CBF n = 57). CBF was associated with a shorter length of stay (mean difference 11.8 days, p < 0.001) and earlier discharge (35.5 vs. 36.9 weeks' PMA, p < 0.001). Weight and head circumference Z-scores at discharge were comparable. Across follow-up, both groups demonstrated declines in weight- and length-for-age Z-scores, with consistently higher values in the TF group (weight: p = 0.004; length: p = 0.003). Total MCHFS scores and prevalence of feeding difficulties at two years were similar. However, coercive feeding behaviors were significantly more common in the TF group (p = 0.018 and p = 0.044).
Conclusion:
CBF was associated with earlier discharge and more adaptive parent-infant feeding interactions while supporting overall normal growth. Integrating responsive feeding with structured nutritional monitoring may optimize both somatic and relational outcomes in preterm infants.
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