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To compare the safety of cup feeding, an alternative feeding method, with bottle feeding, the current standard of artificial feeding in the USA, in premature infants whose mothers intend to breastfeed. |
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≤ 34 corrected gestation weeks |
HR (p<0.0001) and RR (p<0.0001) increased and SatO2 decreased (p=0.0002) during cup and bottle feeding compared to pre-feeding baselines. The fraction of SatO2 <90% during baseline was different between these two methods (p=0.02). There was a 10-fold increase in desaturations <90% during bottle feeding. Comparing periods of cup and bottle feeding, HR were higher (p=0.009) and SatO2 lower (p=0.02) during bottle feeding. There were no differences between methods in RR, choking, spitting or apnea and bradycardia. The volumes removed were smaller (p=0.001) and the duration of feedings was longer (p=0.002) in the cup group. |
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Rocha, N. M. N et al(13)
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2002
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J Hum Lact
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Brazil
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ICU
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Examine the impact of cup or bottle feeding on weight gain, oxygen saturation, and breastfeeding rates in premature infants. |
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Cup and bottle
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The babies were divided according to 3 birth weights: 500 g to 999 g, 1000 g to 1499 g and 1500 g to 1699 g, and were randomly assigned to one of the feeding groups.
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GI= 44 babies for the cup;
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GC=34 babies to the bottle.
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Postconceptional age ranged from 35 to 44 weeks in the bottle group (CG) and from 34 to 42 weeks in the cup group (GI). |
At the beginning of oral feeding, post-conceptional age and weight were 37.2 ± 2.2 weeks and 1676 ± 83 g for the bottle-feeding group (CG) and 37.0 ± 1.6 weeks and 1637 ± 40 g for the GI. No significant differences were found between the groups in relation to time spent eating, feeding problems, weight gain or prevalence of breastfeeding at discharge or at the 3rd month of follow-up. When feeding with a cup, the incidence of desaturation episodes was lower (13.6% vs 35.3%, GI vs CG, P = 0.024) and the prevalence of breastfeeding at the 3rd month was higher among those who were still breastfeeding at the first follow-up appointment (68.4% vs 33.3%, GI vs CG, P = 0.04). |
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Puckett, B. et al(14)
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2008
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Am J Perinatol
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Canada
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ICU
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To determine whether an unscheduled feeding protocol led infants to alter behavior during feeding and, as such, whether feeding based on behavioral assessment would result in decreased hospital stay. |
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Postconceptual age (PCA) of 32 weeks |
There was no difference between groups in average weight gain; in the control group the average weight gain was 12.5 g/kg/day and in the intervention group 12.1 g/kg/day (p = 0.83). The average length of stay in the control group of 14.5 days was significantly longer than the 10.0 days in the intervention group (p = 0.009). The average total number of adverse events in the control group (12.5 events) was significantly higher than in the intervention group (3.5 events; p= 0.007). The average post-conceptual age at study entry was 34.4 weeks in both groups and at exit 36.5 weeks in the control group and 35.8 weeks in the intervention group, a significant difference (p = 0.02) . The intervention group showed 2.8 behavior/eating. |
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To evaluate the suitability and feasibility of spoon feeding in terms of physical growth and transition to breastfeeding in low birth weight (LBW) newborns discharged early from hospital. |
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Non-nutritive spooning and sucking (SNN) Trial I, infants were gradually transitioned from nasogastric feeding and spoon feeding to breastfeeding in the hospital.
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In Trial II, babies transitioned from spoon feeding to BF in the hospital and at home.
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GI: 79 newborns;
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GC: 65 newborns.
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Gestational age ≥ 32 weeks to ≤ 36 weeks corrected age. |
The average weight gain in Trial I was 4.72 (4.68) g kg-1 per day in the NG-feeding group and 4.47 (3.14) g kg-1 per day in the spoon-feeding group ( P = 0.8836). Similarly, spoon-fed infants gained 7.06 (4.26) g kg-1 per day in the hospital group, while they gained 7.56 (3.31) g kg-1 per day in the home group (P = 0 .5984) during the 28-day study period. After randomization, the transition time to BF was 12.31 (3.32) days and 14.39 (4.10) days (P = 0.0201) in Trial I, while 3.55 days and 9 .81 days (P = 0.0000) in Trial II in the two groups, respectively. In Trial II, the average duration of hospital stay was 14.58 (2.83) days in the hospital group and 10.19 (2.26) days in the home group (P = 0.0000). |
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To investigate the effect of applying the smell of breast milk to premature infants during gavage feeding in the transition period to full oral feeding. |
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Born after the 28th or before the 34th week of gestation. |
The results indicated that premature babies who were stimulated by the odor of breast milk during gavage feeding achieved oral feeding 3 days earlier than controls. Furthermore, the average length of stay for these infants was 4 days shorter. |
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To determine the effect of bottle and cup feeding on breastfeeding rates in late preterm infants 32 to 35 weeks during their hospital stay, as well as at discharge and at 3 and 6 months later. |
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Cup and bottle
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GI=254 cup fed;
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GC=268 bottle-fed.
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32 to 35 weeks |
Infants randomized to cup versus bottle were more likely to be exclusively breastfed at discharge and at home (relative risk [RR], 1.58; 95% confidence interval [CI], 1.36-1.83), 3 months after discharge (RR, 1.64; 95% CI, 1.42-1.89), and 6 months after discharge (RR, 1.36; 95% CI, 1.14-1.63). The average hospital stay was 25.96 ± 2.20 days in the bottle group and 25.68 ± 2.22 days in the cup group. There was no significant difference between groups for time spent eating, feeding problems or weight gain in hospital. |
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To compare and evaluate the effectiveness of non-nutritive sucking (NNS) and oral stimulation (EO), applied alone or in combination, to improve oral feeding in premature newborns. |
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Non-nutritive sucking (NNS) (pacifier) and oral stimulation (EO)
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One hundred and twelve preterm infants were divided into three intervention groups (SNN, EO and SNN + EO combined) and a control group.
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28 babies per group.
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Born between 29 and 34 weeks of GA |
The transition time was reduced in the three intervention groups compared to the control group (p< 0.001). The milk transfer rate in the three intervention groups was higher than in the control group (F3,363=15.37; p<0.001). The proficiency in the SNN and EO groups did not exceed that of the control group, while the proficiency in the SNN + EO group was higher than that in the control group at the stage in which the infants started oral feeding (p=0.035). Among all groups, no significant difference was found in weight gain and length of stay. |
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To investigate the impact of 2 feeding intervals, i.e., 3 hours or 2 hours, on the transition time from gavage to full oral feeding in premature babies. |
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Post-conceptional age ≤ 32 and <36 weeks of gestation |
Gestational age: 29 [28–31] weeks, birth weight: 1205 [1040–1380] g. The postconceptional age to achieve full oral feeding was 35 (35–37) weeks in the 3-hour interval group and 35 (34–36) weeks in the 2-hour interval group, P = 0.131. The duration of the dietary transition was similar between the groups. |
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Nunes, J. D. et al(20)
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2019
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CoDAS
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Brazil
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ICU
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To evaluate oxygen saturation (SatO2), heart rate (HR), length of stay and weight of preterm newborns (PTNBs) in a Neonatal Intensive Care Unit, when offering a diet using cup feeding techniques and finger probe, simultaneously with AM. |
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Gestational age (GA) of 35 to 36 weeks (Capurro method) |
Regarding the SatO2 and HR variables, no statistically significant differences were observed between the groups, but, in the group versus time factor, the groups showed non-continuous differences in the SatO2 variable. In relation to weight, a statistically significant gain was found for both groups. However, in GCP, their weight gain is due to the longer hospital stay. The GSD had a shorter hospital stay. |
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Buldur, E. et al (21)
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2020
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Breastfeeding Medicine
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Turkiye
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ICU
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To compare finger tube feeding and syringe feeding on the sucking ability of premature babies in the first days of life. |
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Group 1 was ≥ 31 to ≤ 34 weeks; Group 2 was 30-35 weeks |
Comfort and distress scores were determined using the COMFORTneo scale. Babies in the intervention group had better comfort than those in the CG (p = 0.000). The transition time to breastfeeding was significantly shorter than in the CG (19.4 – 15.0 days versus 29.7 – 10.2 days, p = 0.000). The GI had less milk loss during feeding and its average weight gain at the end of the 10th day was significantly higher (322.1 – 82.3 g versus 252 – 108.4 g, p = 0.004). They were also discharged before the GC (25.8 – 17.4 days versus 35.9 – 13.0 days, p = 0.001). |