Related Experiment Videos
Effects of bottle feeding and two different methods of gavage feeding on oxygenation and breathing patterns in
C F Poets1, M U Langner, B Bohnhorst
1Department of Paediatric Pulmonology, Hannover Medical School, Germany.
Insights
Bottle feeding significantly increases oxygen desaturation in preterm infants compared to gavage feeding. Gavage feeding effectively reduces these events, with no added benefit from slow over bolus administration.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Respiratory Physiology
Background:
- Preterm infants often experience cardiorespiratory events during feeding.
- Feeding methods can influence physiological stability in vulnerable infants.
Purpose of the Study:
- To compare the effects of bottle feeding versus two gavage feeding methods on apnoea, bradycardia, and oxygen desaturation in preterm infants.
Main Methods:
- Thirty preterm infants underwent 9-hour recordings monitoring SpO2, heart rate, and respiratory parameters.
- Feeding methods included bottle feeding, bolus gavage, and slow gavage (1-hour infusion).
- Apnoeas, bradycardias, and desaturations (SpO2 < 80%) were analyzed.
Main Results:
- Bottle feeding resulted in three times more desaturations than bolus gavage feeding (p < 0.001).
- Desaturations were significantly higher during the feeding hour and for 2 hours post-feeding with bottle feeding compared to gavage.
- No significant differences in apnoea or bradycardia frequency were observed between feeding techniques.
Conclusions:
- Bottle feeding can cause significant oxygen desaturation in preterm infants.
- Gavage feeding is an effective method to reduce feeding-related hypoxemia.
- Slow gavage feeding does not offer superior protection against hypoxemia compared to bolus gavage feeding.
Objective:
To determine the effect of bottle feeding, as compared to two methods of gavage feeding, on apnoea, bradycardia and oxygen desaturation frequency.
Patients:
Thirty preterm infants breathing room air; gestational age 28.6 +/- 2.1 weeks at birth and 34 +/- 1.4 weeks at study (mean +/- SD).
Methods:
Nine-hour recordings of pulse oximeter saturation (SpO2), pulse waveforms, electrocardiogram, breathing movements and nasal airflow. Administration of 21 +/- 1.5 ml/kg of milk/feed in 3-h intervals using three different feeding techniques in random order: bottle feeding, bolus gavage feeding, and slow gavage feeding (1 h). Analysis of recordings for apnoeas (> or =4s, bradycardias (heart rate < 2/3 of baseline), and episodic desaturation (SpO2 < or = 80%).
Results:
There were three times more desaturations with bottle feeding than with bolus gavage feeding (p < 0.001), but no further reduction with slow gavage feeding. With all three feeding techniques, there were significantly more desaturations in the hour when the feeds were given than during the following 2 h. The deleterious effects of bottle feeding were most evident during the hour of feeding, but desaturation frequency remained significantly higher than with gavage feeding during the following 2 h. There was no significant effect of feeding technique on the frequency of apnoea or bradycardia.
Conclusions:
Preterm infants who are normally oxygenated in room air may have significant desaturation during bottle feeding. Such desaturation can be effectively reduced by gavage feeding. Slow gavage feeding offers no advantage over bolus gavage feeding with respect to the avoidance of hypoxaemia.