Comparison of Bottle and Cup Feeding on Transition to Full Breastfeeding and Discharge Time

The Effects of Oral Feeding Methods in Preterm Infants on Transition to Full Breastfeeding and Discharge Time: A Retrospective Study

Breastfeeding is the ideal feeding method and that in the absence of breastfeeding the bottle and cup feeding are common alternatives. There is a lack of evidence regarding superiority of either of these methods. This study aimed to evaluate bottle feeding and cup feeding in preterm infants on the outcomes of full breastfeeding and discharge time.

Study Overview

• Status: Completed
• Conditions: Feeding Behavior; Preterm; Feeding, Bottle; Feeding, Breast
• Intervention / Treatment: Device: Bottle feeding; Device: Cup feeding

Detailed Description

An estimated 20 million infants are born preterm each year (>37 weeks) and this number is increasing. The preterm newborn population is potentially unable to be fed orally for a long time in the postnatal period.However, it is not a disease that preterm infants cannot be fed orally as soon as they are born. Since the physiological functions are not yet fully mature, their adaptation to the external uterine environment is more complicated.This situation also means a long hospital stay. Therefore, the American Academy of Pediatrics (AAP) has determined oral feeding of the preterm baby as the main criterion for discharge.

In preterm infants, sucking and swallowing coordination occurs in the 32 to 34 gestation weeks.Oral feeding skills are developed by applying various sensorimotor interventions and cue-based feeding protocols to increase oral feeding performance.Tube feeding (orogastric and nasogastric) is widely preferred as their oral-motor skills are still immature.As postnatal age increases, alternative oral feeding methods are often used along with tube feeding.Bottle feeding, cup feeding spoon feeding and syringe feeding are the most popular methods in clinical practice. While determining the most available method of oral feeding in preterm infants, the selection criteria include their capacity to facilitate the transition to full breastfeeding to help sustain breastfeeding to shorten the duration of hospitalization and to ensure sufficient nutrition.

Direct full breastfeeding is the important and most recommended feeding method in new-borns. However, since full breastfeeding is not immediately possible in preterm infants, they definitely need an alternative feeding method.

• Study Type: Observational
• Enrollment (Actual): 158

Contacts and Locations

Study Locations

• Turkey
  • Denizli, Turkey, 20160
    • Pamukkale University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 months to 7 months (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Preterm infants between 30-34 weeks and healthy

Description

Inclusion Criteria:

• Preterm infants (30-34 weeks);
• Considered medically stable
• With no facial deformity,
• Absent of neurological or congenital anomalies,
• Did not require sedation or vasoactive drugs
• Mother is providing breast milk & plans to breastfeed.

Exclusion Criteria:

• Presence of gastrointestinal conditions that complicate feeding such as NEC,
• Absence of mother,
• Absence of breast milk, and
• Preterm infants fed only formula

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Crossover
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Bottle Feeding; The bottle feeding method was being used in the NICU (1 January -31 December 2018).	Device: Bottle feeding; Bottle was used as an alternative oral feeding method for preterm infants.
Cup Feeding; The cup feeding method was being used in the NICU (1 January -31 December 2019).	Device: Cup feeding; Cup was used as an alternative oral feeding method for preterm infants.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Transition to Full Breastfeeding	Preterm infants fed with bottle (n=78) and cup (n=80) were compared in terms of transition to full breastfeeding. The transition period from oral feeding to full breastfeeding is different for every preterm infants. There is no specific time frame in the study. For this outcome, infants were evaluated for time from oral feeding to full breastfeeding.	From transition to breastfeeding, up to 1 week.
Discharge Time	Preterm infants fed with bottle (n=78) and cup (n=80) were compared in terms of discharge times. There is no specific time frame in the study. For this outcome, infants were evaluated for lenght of stay hospital.	From admission to discharge, up to 4 weeks

Collaborators and Investigators

• Sponsor: Pamukkale University
• Investigators: Principal Investigator: Zühal Çamur, RN, PhD, Pamukkale University; Study Director: Bengü Çetinkaya, RN, PhD, Pamukkale University

Study record dates

Study Major Dates

• Study Start (Actual): February 20, 2020
• Primary Completion (Actual): April 30, 2020
• Study Completion (Actual): May 20, 2020

Study Registration Dates

• First Submitted: July 12, 2021
• First Submitted That Met QC Criteria: July 21, 2021
• First Posted (Actual): July 23, 2021

Study Record Updates

• Last Update Posted (Actual): July 23, 2021
• Last Update Submitted That Met QC Criteria: July 21, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Keywords: Bottle feeding; Breastfeeding; Preterm infants; Cup feeding; Feeding methods
• Additional Relevant MeSH Terms: Pregnancy Complications; Obstetric Labor Complications; Obstetric Labor, Premature; Premature Birth
• Other Study ID Numbers: Cup feeding, Bottle feeding

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No