Characteristics of included studies [ordered by study ID]
Collins 2004
|
| Methods | Randomised controlled trial.
Allocation concealment (blinding of randomisation): Yes
Blinding of intervention: No
Completeness of follow up: Yes
Blinding of outcome measurement: No |
|
| | Participants | 319 Preterm infants (Cup feeding group n=161; bottle feeding group n=158) (mean gestational ages 29.3 and 30.0 weeks); Conducted in Australia; Involved 2 tertiary hospitals and 54 peripheral hospitals (this number of peripheral hospitals were involved as they were the receiving hospitals for the babies from the tertiary hospitals).
Eligibility criteria: preterm infants less than 34 weeks gestational age whose mothers wanted to breastfeed. |
|
| | Interventions | Randomised to supplemental feeds via cup or bottle |
|
| | Outcomes | Not breastfeeding at hospital discharge: number assessed - cup feeding group N=151; bottle feeding group N=152.
Not breastfeeding at 3 months: number assessed - cup feeding group N=144; bottle feeding group N=139
Not breastfeeding at 6 months: number assessed - cup feeding group N=142; bottle feeding group N=139
Not fully breastfeeding at hospital discharge: number assessed - cup feeding group N=151; bottle feeding group N=152
Not fully breastfeeding at 3 months: number assessed - cup feeding group N=144; bottle feeding group N=139
Not fully breastfeeding at 6 months: number assessed - cup feeding group N=142; bottle feeding group N=139
Length of hospital stay: number assessed - cup feeding group N=149; bottle feeding group N=152 |
|
| | Notes | Results are an evaluation of infants followed at 3 & 6 months and not all infants randomised |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Allocation concealment? | Yes | A - Adequate |
|
|
Gilks 2004
|
| Methods | Randomised Controlled Trial
Allocation concealment (blinding of randomisation): Yes (assignments concealed in sequentially numbered opaque envelopes held in an independent ward to the nursery within each hospital).
Blinding of intervention: No
Completeness of follow up: Yes at hospital discharge; no thereafter
Blinding of outcome measurement: No |
|
| | Participants | 54 Preterm infants (Cup feeding group n=27; bottle feeding group n=27) (mean gestational ages 31.0 and 32.0 weeks); Conducted in the UK; single centre trial
Eligibility Criteria: preterm infants who were less than 35 weeks completed gestation and more than 30 weeks gestation whose mothers intended to breastfeed. |
|
| | Interventions | Randomised to supplemental feeds via cup or bottle |
|
| | Outcomes | Not breastfeeding at hospital discharge: number assessed - cup feeding group N=27; bottle feeding group N=27
Not fully breastfeeding at hospital discharge: number assessed - cup feeding group N=27; bottle feeding group N=27.
This study also looked at the following outcomes: breast feeding rates at term, at six weeks post term and post conceptional age. |
|
| | Notes | |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Allocation concealment? | Yes | A - Adequate |
|
|
Mosley 2001
|
| Methods | Randomised Controlled Trial
Allocation concealment (blinding of randomisation): Yes (concealed cards in envelopes)
Blinding of intervention: No
Completeness of follow up: Yes at hospital discharge; no thereafter
Blinding of outcome measurement: No |
|
| | Participants | 16 Preterm infants (Cup feeding group n=8; bottle feeding group n=8) (mean gestational age of 35.2 to 35.5 weeks); Conducted in the UK; single centre trial
Eligibility Criteria: preterm infants who were between 30 and 37 weeks gestation, admitted to the special care nursery, whose mothers intended to breastfeed. |
|
| | Interventions | Randomised to supplemental feeds via cup or bottle |
|
| | Outcomes | Not fully breastfeeding at hospital discharge: number assessed - cup feeding group N=6; bottle feeding group N=8. |
|
| | Notes | |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Allocation concealment? | Yes | A - Adequate |
|
|
Rocha 2002
|
| Methods | Randomised Controlled Trial
Allocation concealment (blinding of randomisation): Yes (sealed numbered opaque envelope)
Blinding of intervention: No
Completeness of follow up: Yes at hospital discharge; no thereafter
Blinding of outcome measurement: No |
|
| | Participants | 83 Preterm infants (Cup feeding group n=46; bottle feeding group n=37) (mean gestational age of 32.5 to 32.7 weeks); Conducted in Brazil; single centre trial
Eligibility Criteria: preterm infants who were born between 32 and 36 weeks gestation, and weighting less than 1700 g, admitted to the intensive care nursery, whose mothers intended to breastfeed. |
|
| | Interventions | Randomised to supplemental feeds via cup or bottle |
|
| | Outcomes | Not breastfeeding at hospital discharge: number assessed - cup feeding group N=44; bottle feeding group N=34.
Not breastfeeding at 3 months: number assessed - cup feeding group N=44; bottle feeding group N=34.
Weight gain: number assessed - cup feeding group N=44; bottle feeding group N=34.
Average time per feed: number assessed - cup feeding group N=44; bottle feeding group N=34.
Other outcomes assessed: differences between oxygen saturation levels in bottle, cup and breast-fed infants. |
|
| | Notes | |
|
| | Risk of bias |
| | Item | Authors' judgement | Description |
| | Allocation concealment? | Unclear | B - Unclear |
|
|
Characteristics of excluded studies [ordered by study ID]
|
| Study | Reason for exclusion |
|---|
| | Brown 1999 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. A retrospective chart review. |
| | Davis 1948 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. |
| | Dowling 2001 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. Descriptive literature on nipple confusion and alternative feeding methods. |
| | Dowling 2002 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. A non-experimental convenience sample. |
| | Fredeen 1948 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. A descriptive report on experience with cup feeding of newborn infants |
| | Freer 1999 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. A convenience sample of newborn infants exposed to breast and cup feeding |
| | Gupta 1999 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. A retrospective chart review. |
| | Howard 1999 | A randomised controlled trial of formula feeding infants only. Infants randomised to either receive feeds via cup or bottle. A group of exclusively breast feeding infants were used as a comparison group. |
| | Howard 2003 | This study did not meet the inclusion criteria for this review as participants were not infants that were unable to fully breastfeed. Participants were infant-mother dyads. Unborn infants were randomised on maternal admission to either early or late pacifier use or cup or bottle supplemental feeding if required. A large proportion of the babies randomised were part of the study because of maternal choice to offer supplemental feeds not because the infants were unable to fully breastfeed. |
| | Malhotra 1999 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. Crossover design was employed. |
| | Marinelli 2001 | Was neither a randomised controlled trial nor a non-randomised controlled trial using quasi-randomised group allocation. Crossover design was employed. |
|
|
Comparison 1. Supplemental feed using cup versus bottle
|
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|
| | 1 Weight gain (g/kg/day) | 1 | | Mean Difference (IV, Fixed, 95% CI) | Totals not selected |
| | 2 Not breastfeeding at hospital discharge | 3 | 435 | Risk Ratio (M-H, Fixed, 95% CI) | 0.82 [0.62, 1.09] |
| | 3 Not breastfeeding at three months | 2 | 361 | Risk Ratio (M-H, Fixed, 95% CI) | 0.88 [0.76, 1.03] |
| | 4 Not breastfeeding at six months | 1 | | Risk Ratio (M-H, Fixed, 95% CI) | Totals not selected |
| | 5 Not fully breastfeeding at hospital discharge | 3 | 371 | Risk Ratio (M-H, Fixed, 95% CI) | 0.75 [0.61, 0.92] |
| | 6 Not fully breastfeeding at three months | 1 | | Risk Ratio (M-H, Fixed, 95% CI) | Totals not selected |
| | 7 Not fully breastfeeding at six months | 1 | | Risk Ratio (M-H, Fixed, 95% CI) | Totals not selected |
| | 8 Average time per feed (minutes) | 1 | | Mean Difference (IV, Fixed, 95% CI) | Totals not selected |
| | 9 Length of stay (days) | 1 | | Mean Difference (IV, Fixed, 95% CI) | Totals not selected |
|
|
