ARS | Publication request: Oral Feeding in Premature Infants: Advantage of a Self-Paced Milk Flow

Submitted to: Acta Paediatrica
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: January 25, 2000
Publication Date: N/A

Interpretive Summary: Babies who are born prematurely can have a host of problems relating to the fact that they are not fully developed. One big problem is trying to help these babies achieve full oral feeding, which is tied to their discharge from the hospital. These babies, who are often seriously underweight, must learn how to coordinate sucking, swallowing and breathing so that they don't choke on the milk they are trying to drink, and at the same time, increase their weight. Doctors want to determine ways of improving this process so these babies can catch up with regard to development. A previous study showed that oral feeding of premature infants (of less than 30 weeks gestation) was improved when milk was fed via a self-paced flow system. This study sought to identify the principles by which this occurred, and develop a practical method to use this system in hospital nurseries. We studied premature infants at three time periods, when they were taking 1-2, ,3-5, and 6-8 oral feedings per day. We fed the infants using a self-paced system, a standard bottle, and a test bottle that eliminated the inner water pressure. In a second study, the babies were similarly fed with the self-paced system and a vacuum-free bottle that eliminated both the inner water pressure and vacuum. The duration of oral feedings, the efficiency and the percentage of successful feedings were improved with the self-paced system compared to the standard and test bottles. The results were similar in the comparison between the self-paced system and vacuum-free bottle. We found that eliminating the vacuum buildup that normally occurs inside the bottle improves the feeding performance of premature infants as they progress from tube to oral feeding. Thus, the vacuum-free bottle is a useful tool that can be easily used in nurseries.

Technical Abstract: An earlier study demonstrated that oral feeding of premature infants (<30 wk gestation) was enhanced when milk was delivered through a self-paced flow system. The aims of this study were to identify the principle(s) by which this occurred and to develop a practical method to implement the self-paced system in neonatal nurseries. Feeding performance, measured by overall transfer, duration of oral feedings, efficiency, and percentage of successful feedings, was assessed at three time periods, when infants were taking 1-2, 3-5, and 6-8 oral feedings/day. At each time period, infants were fed, sequentially and in a random order, with a self-paced system, a standard bottle, and a test bottle, the shape of which allowed the elimination of the internal hydrostatic pressure. In a second study, infants were similarly fed with the self-paced system and a vacuum-free bottle which eliminated both hydrostatic pressure and vacuum within the bottle. The duration of oral feedings, efficiency, and percentage of successful feedings were improved with the self-paced system as compared to the standard and test bottles. The results were similar in the comparison between the self-paced system and the vacuum-free bottle.