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Updated: Jul 31, 2026

Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Suction patterns in preterm infants
M Martell1, G Martínez, M González
1Uruguay Center of Perinatology, Montevideo.
Insights
Preterm infants show delayed suction initiation, with feeding efficiency improving with gestational age. Bottle feeding is quicker than breastfeeding but less efficient initially for preterm neonates.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Infant Feeding Practices
Background:
- Preterm infants often require specialized feeding methods due to immature oral motor skills.
- Understanding suction patterns is crucial for optimizing nutritional intake and development in premature infants.
- Previous research has explored various feeding modalities, but detailed analysis of suction dynamics in preterm infants is ongoing.
Purpose of the Study:
- To describe and compare the suction patterns of preterm infants during breast and bottle feeding.
- To analyze the relationship between gestational age and the development of effective suckling mechanics.
- To evaluate the efficiency and duration of feeding in preterm neonates using different methods.
Main Methods:
- A composite study (longitudinal and transverse) analyzed 16 preterm neonates (from 32 weeks gestation) for breastfeeding suction patterns.
- A transverse study evaluated 46 exclusively bottle-fed preterm neonates (previously orogastrically fed) for bottle feeding dynamics.
- Key parameters measured included time to suction, milk extraction velocity, feeding duration, and suction efficiency.
Main Results:
- Suction initiation was delayed in preterm infants with lower gestational ages for both feeding methods.
- Breastfeeding milk extraction velocity increased with gestational age, approaching mature levels by 36 weeks.
- Bottle feeding duration averaged 3.7 minutes, with 40% of intake in the first minute; suction efficiency was lower initially.
Conclusions:
- Infant's gestational age significantly influences the development of effective sucking patterns and feeding efficiency.
- Bottle feeding offers a shorter feeding time compared to breastfeeding in preterm infants.
- Optimizing feeding strategies based on gestational age and feeding method is essential for preterm infant nutrition.
Abstract:
The suction pattern for breast and bottle feeding in two groups of preterm infants is described. The time elapsed between birth and the moment of suction was longer in preterm neonates born at lower gestational ages for both groups studied, breast and bottle fed (figure 1). The evolution of suckling in breastfeeding was analyzed in a composite study (longitudinal and transverse) in a group of 16 neonates starting from 32 weeks of gestation. The velocity of milk extraction during suckling varied with gestational age. It was uniform at lower gestational ages, then it became faster in the first minutes and at the 36th week, it was very similar to that of mature neonates (figure 2 and table I). The evaluation of bottle feeding was performed in a transverse study in 46 preterm neonates which had been exclusively bottle fed during 1 or 2 weeks. All of them had previously been fed using an orogastric tube. Nourishing time was shorter than in breastfeeding; the average duration was 3.7 minutes (table II). The greatest volume was ingested in the first minute, 40% (range between 44 and 25%) (figure 3). The frequency of suction did not change the duration of feeding, but it was found that the efficiency of suction (number of suctions to ingest 1 cc) was significantly lower in the first minute (Anova, p < 0.05) (figure 4).
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