Abstract
BackgroundAlthough previous studies have demonstrated beneficial breastfeeding outcomes when cup feeding rather than bottle feeding was used for feeding preterm infants, cup feeding has not been implemented in Egypt. The aim of the current study was to examine the effect of using cup feeding as an exclusive method of feeding preterm infants during hospitalization on breastfeeding outcomes after discharge.MethodsA quasi-experimental design, with the control group studied first, was used to examine the effect of cup feeding for preterm infants on breastfeeding outcomes after discharge. Sixty preterm infants (mean gestational age was 35.13 weeks and mean birth weight was 2150 grams) were recruited during Neonatal Intensive Care Unit (NICU) stay. Control group infants (n = 30) received only bottle feedings during hospitalization and the experimental group (n = 30) received only cup feedings during hospitalization. Both groups were followed up after discharge for six weeks to evaluate infant's breastfeeding behavior and mother's breastfeeding practices. Data were analyzed using descriptive statistics and repeated measures ANOVA for testing the differences between the cup feeding and bottle feeding groups over six weeks after discharge.ResultsCup fed infants demonstrated significantly more mature breastfeeding behaviors when compared to bottle fed infants (p < 0.01) over six weeks, and had a significantly higher proportion of breast feedings one week after discharge (p = 0.03).ConclusionCup fed infants were more exclusively breast fed one week after discharge, supporting the Baby Friendly Hospital Initiative recommendations for using cup feeding and avoiding bottle feeding when providing supplementation for preterm infants. The current study provides initial evidence for the implementation of cup feeding as a method of supplementation for late preterm infants during hospitalization.Trial RegistrationClinical Trial NCT00756587.
Highlights
Previous studies have demonstrated beneficial breastfeeding outcomes when cup feeding rather than bottle feeding was used for feeding preterm infants, cup feeding has not been implemented in Egypt
The following research questions were addressed: (1) Are premature infants supplemented by cup during hospitalization more likely to be fully breastfed six weeks after discharge when compared to premature infants supplemented by bottle during hospitalization?, and (2) Do preterm infants supplemented by cup during hospitalization demonstrate more mature breastfeeding behavior at 1, 2, 3, 4, 5, and 6 weeks after discharge when compared to preterm infants supplemented by bottle?
Research question 1 Are premature infants supplemented by cup during hospitalization more likely to be fully breastfed six weeks after discharge when compared to premature infants supplemented by bottle during hospitalization?
Summary
Previous studies have demonstrated beneficial breastfeeding outcomes when cup feeding rather than bottle feeding was used for feeding preterm infants, cup feeding has not been implemented in Egypt. The aim of the current study was to examine the effect of using cup feeding as an exclusive method of feeding preterm infants during hospitalization on breastfeeding outcomes after discharge. One of the issues that presents during the transition to breastfeeding is that mothers of preterm infants are rarely available for all oral feedings during hospitalization; making it necessary for infants to receive oral feedings by other methods, usually bottle feeding. Exposure of newborn infants to artificial nipples has been strongly associated with breastfeeding problems [5,6,7,8,9]. These problems have been explained by a phenomenon called nipple confusion. It has been recommended that bottle feeding be avoided and that cup feeding be used for the supplementation of term [11,12] as well as preterm infants [13,14,15]
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