Clinical trial NCT00838188: Energy Expenditure in Breast and Bottle Feeding Preterm Infants Fed Their Mother's Breast Milk
Official title: Energy Expenditure in Breast and Bottle Feeding Preterm Infants Fed Their Mother's Breast Milk
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Preterm Infants
Keywords: Metabolic rate
indirect calorimetry
oral feeding
Lead sponsor: Tel-Aviv Sourasky Medical Center
Sponsor class: OTHER_GOV
First posted: 2009-02-06
Enrollment: 23
Sex: ALL
Minimum age (years): 34
Maximum age (years): 40
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: CASE_CROSSOVER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Preterm infants born after 32 weeks of gestation, when they reached the corrected gestational age of 34 weeks or more.

Brief summary: OBJECTIVE. Neonatologists consider early feeding at the breast to be too tiring for preterm infants, although there is no evidence that this is actually the case. It is also not known whether the method of feeding affects energy expenditure. We hypothesized that resting energy expenditure (REE) would be higher after breastfeeding than after bottle feeding.

PATIENTS AND METHODS. preterm ( \>32 weeks GA) stable infants who are nourished entirely by their mothers' breast milk will be studied when fed expressed breast milk either by bottle or at the breast. REE will be measured for 20 minutes after feeding. Breast milk quantity is evaluated by pre- and post feeding weighing.

Detailed description: Most VLBW infants cannot be fed at the breast upon birth, and expressed breast milk by gastric tube is thus recommended. Sucking skills mature at around 34 weeks when nipple-feeding is introduced. In the absence of evidence-based data to decide the best timing to introduce breastfeeding, many clinicians use empiric criteria, such as the infant's weight, gestational age, and the ability of infants to bottle feed as proxies of readiness to breastfeed. Despite some evidence of physiological benefits of preterm infants feeding at the breast, many neonatologists consider direct breastfeeding to be too fatiguing for preterm infants. It is not known, however, whether preterm infants who are breastfed expend more energy than bottle-fed infants

Eligibility criteria: Inclusion Criteria:

* Thermally stable infants were nursed in an open and unwarmed bassinet.
* All fed solely by their mothers' breast milk equivalent to at least 150 cc/kg/day divided into eight meals and growing steadily

Exclusion Criteria:

* Infants with congenital anomalies and infants who had either more than five daily episodes of apnea of prematurity or any apnea requiring assistance or methylxanthine therapy

Primary outcomes:
measure: The primary goal of this study was to compare resting energy expenditure (REE) in preterm infants who were fed their mothers' expressed milk by bottle and at the breast
timeFrame: 20 minutes after each meal
Secondary outcomes:
measure: Creamatocrit of the bottle at the beginning and the completion of every feeding at the breast were measured
timeFrame: Not relevant
Other outcomes:
Locations:
city: Tel Aviv
country: Israel
facility: Department of Neonatology, Tel Aviv Sourasky Medical Center
city: Tel-Aviv
country: Israel
facility: Sourasky Medical Center
Study officials:
name: Irit Berger, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Berger I, Weintraub V, Dollberg S, Kopolovitz R, Mandel D. Energy expenditure for breastfeeding and bottle-feeding preterm infants. Pediatrics. 2009 Dec;124(6):e1149-52. doi: 10.1542/peds.2009-0165. Epub 2009 Nov 23.