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A randomised trial of two techniques for bottle feeding preterm infants

Authors

  • Jennifer A Dawson,

    Corresponding author
    1. Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    2. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
    • Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
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  • Leanne R Myers,

    1. Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
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  • Anita Moorhead,

    1. Breastfeeding Education and Support Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
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  • Susan E Jacobs,

    1. Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    3. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
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  • Katherine Ong,

    1. Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Speech Pathology Department, Royal Children's Hospital, Melbourne, Victoria, Australia
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  • Frances Salo,

    1. Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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  • Sally Murray,

    1. Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
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  • Susan Donath,

    1. Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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  • Peter G Davis

    1. Neonatal Services, The Royal Women's Hospital, Melbourne, Victoria, Australia
    2. Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
    3. Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
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  • Author contributions:
  • JAD Contributed to study design, collected, analysed and interpreted data, drafted the manuscript.

    LM Conceived the study, contributed to study design, data collection and editing of manuscript.

    AM Contributed to study design, data interpretation and editing the manuscript.

    SJ Contributed to study design, data interpretation and editing the manuscript.

    KO Contributed to study design, editing the manuscript.

    FS Contributed to study design, editing the manuscript.

    SM Contributed to study design, editing the manuscript.

    SD Supervised data analysis, data interpretation and editing the manuscript.

    PGD Contributed to study design, data interpretation, drafting the manuscript, supervision of all aspects of the study.

  • All authors approved the final version of the manuscript.
  • Conflict of interest: The authors have no competing interests to declare.

Correspondence: Dr Jennifer Dawson, Neonatal Services, The Royal Women's Hospital, Corner Grattan Street and Flemington Road, Parkville, Vic. 3052, Australia. Fax: 61 3 8345 3789; email: jennifer.dawson@thewomens.org.au

Abstract

Aim

Preterm infants begin the transition from gastric tube feeds to sucking feeds around 34 weeks' postmenstrual age. We compared physiological stability in two bottle feeding positions, cradle hold versus side lying in preterm infants.

Methods

Randomised crossover trial of infants <34 weeks' gestation at birth, ≥34 weeks' postmenstrual age at study and receiving at least two sucking feeds/day. Two feeds were studied on successive days. A pulse oximeter measured oxygen saturation (SpO2) and heart rate (HR) before, during and 30 min after feeds. Continuous data were compared using paired t-tests and proportions using chi squared.

Results

Twenty-five study infants were mean (standard deviation (SD)) 37 (2.4) weeks' post-menstrual age and 2740 (589) g at study. There was little difference in mean (SD) SpO2 during feeds between the cradle-hold and side-lying position 94 (6) % versus 95 (6) %, respectively (P = 0.55, confidence interval (CI) −1.4, 5.4). During feeds, 17/25 (68%) experienced a period of SpO2 <80% in the cradle-hold position compared with 14/25 (56) % in the side-lying position (P = 0.26, CI 0.68, 4.10). There were no significant differences in the mean HR or number of episodes of bradycardia HR <100 bpm. There was a trend towards infants consuming a smaller mean (SD) proportion of their feed in the cradle-hold position compared with the side-lying position, 82 (25) % versus 87 (20) % (P = 0.08, CI −0.64, 10.00).

Conclusions

There was little difference in infants' physiological stability between the two bottle feeding positions. Both methods may be appropriate for the transition from gastric tube to sucking feeds in preterm infants.

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