Cup Versus Bottle Feeding for Late Preterm Infants
Condition: Breastfeeding
MeSH terms: Premature Birth
Study type: Interventional

Summary: 
      The purpose of the current study is to investigate the effect of using cup feeding for
      preterm infants during NICU stay on breastfeeding outcomes after discharge. The following
      hypotheses are being tested:

        1. Infants Fed by cup during NICU stay will have higher breastfeeding proportions than
           infants fed by bottle

        2. Infants fed by cup during NICU stay will have higher breastfeeding behaviour score on
           the Preterm Infant Breastfeeding Behavior Scale than infants fed by bottle
    

Detailed description: 
      The provision of breast milk is essential for preterm infants as it provides unique health
      benefits that are unmatched by other types of feeding [1-3]. However, breastfeeding presents
      unique challenges for preterm infants that include establishing and maintaining the mothers'
      milk supply and transitioning the infant from gavage feeding to breastfeeding [4]. 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; this makes it
      necessary for infants to receive oral feedings by other method, usually bottle feeding.

      However, exposure of newborn infants to artificial nipples has been strongly associated with
      breastfeeding problems [5-9]. Frequently these problems have been explained by phenomena
      called nipple confusion. Nipple confusion occurs when infants are exposed to two different
      feeding methods, bottle and breast, resulting in the infant refusing to breastfeed.
      Consequently, it has been recommended that bottle feeding be avoided and that cup feeding be
      used for the supplementation of term as well as preterm infants.

      Cup feeding is known as an alternative method of feeding breast milk to an infant using a
      small cup without a lip. Cup feeding is also recommended by the Baby Friendly Hospital
      Initiative.The use of cup was originally based on the goal of avoiding propping of bottles
      and also to increase bodily contact with the mother during feeding. Although cup feeding
      receives little mention in medical literature, and may seem to be a new technique for some,
      it has been used in several developing as well as developed countries. Lang, who observed cup
      feeding in South Nepal, implemented cup feeding in England and the practice expanded to other
      developed countries. Consequently cup feeding was established as a method for feeding infants
      who could not be breastfed from birth.
    

Intervention name(s): Cup Feeding; Bottle Feeding
Intervention type(s): Device; Device
Intervention description(s): using a cup feeding technique for feeding the preterm infants during NICU stay; receiving all feeding by bottle
Other intervention name(s): Cup-feeding Group; bottle feeding group
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Cup Feeding; late Preterm