Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Mar 19;10(3):376.
doi: 10.3390/nu10030376.

Preterm Infant Feeding: A Mechanistic Comparison between a Vacuum Triggered Novel Teat and Breastfeeding

Donna Geddes  1 , Chooi Kok  2   3 , Kathryn Nancarrow  4   5 , Anna Hepworth  6 , Karen Simmer  7   8
Affiliations
Randomized Controlled Trial

Preterm Infant Feeding: A Mechanistic Comparison between a Vacuum Triggered Novel Teat and Breastfeeding

Donna Geddes et al. Nutrients. .

Abstract

The goal for preterm infants is to achieve full oral feeds quickly and ultimately progress to full breastfeeding. Supplementary oral feeds are often given when the mother is not available to breastfeed. Bottles typically deliver milk in a different fashion compared to breastfeeding, which is thought to hamper transition to full breastfeeding. The aim of this study was to compare the sucking dynamics of preterm infants fed at the breast to feeding with an experimental novel teat (NT) designed to release milk only upon the application of vacuum. Simultaneous ultrasound imaging of the infant oral cavity and measurement of intra-oral vacuum was performed during a breastfeed and a feed with the NT. Test weighs were used to measure milk intake. Linear mixed effects models were performed to investigate differences by feed type, and simultaneous linear regression was performed to investigate individual patterns. Tongue movement was not different between breastfeeding and the NT. Intra-oral vacuums (median (interquartile range: IQR)) were significantly lower with the NT (Baseline vacuum: -5.8 mmHg (-11.0, 0.1); Peak: 40.0 mmHg (-54.6, -27.1)) compared to breastfeeding (Baseline: -31.1 mmHg (-60.0, -12.7); Peak: -106.2 mmHg (-153.0, -65.5)). Milk intake was significantly higher with the NT (33 mL (22.5, 42.5)) compared to the breastfeed (12 mL (3, 15.5)). The novel teat encouraged a similar tongue action to breastfeeding, and infants transferred a greater volume of milk with the novel teat. Intra-oral vacuums were lower in strength with the novel teat compared to the breast. Use of the novel teat for the training of sucking dynamics in preterm infants has the potential to improve breastfeeding success and requires further investigation.

Keywords: bottle; breastfeeding; feeding; human milk; infant; infant feeding; nipple shield; premature; preterm.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest and that Medela AG (Switzerland) provides an unrestricted research grant to Donna Geddes from which salaries to Donna Geddes and Anna Hepworth are paid. Medela AG provided a Top-up Scholarship for Zoya Gridneva and has provided speaker’s fees to Donna Geddes for educational lectures. The funding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
The movement of the infant tongue from its uppermost point to its lowest point for a breastfeed and feed with the novel teat. Solid grey line: breastfeed tongue down; dashed grey line: breastfeed tongue up; solid black line: novel teat tongue down; dashed black line: novel teat tongue up.
Figure 2
Figure 2
Sucking vacuums over the course of both the breastfeed and novel teat feed. Black lines are local regression smoothers for the full data set; grey lines are local regression smoothers indicating individual infant patterns.
See this image and copyright information in PMC

References

    1. Lewandowski A.J., Lamata P., Francis J.M., Piechnik S.K., Ferreira V.M., Boardman H., Neubauer S., Singhal A., Leeson P., Lucas A. Breast milk consumption in preterm neonates and cardiac shape in adulthood. Pediatrics. 2016;138:e20160050. doi: 10.1542/peds.2016-0050. - DOI - PMC - PubMed
    1. Isaacs E.B., Gadian D.G., Sabatini S., Chong W.K., Quinn B.T., Fischl B.R., Lucas A. The effect of early human diet on caudate volumes and IQ. Pediatr. Res. 2008;63:308–314. doi: 10.1203/PDR.0b013e318163a271. - DOI - PubMed
    1. Isaacs E.B., Fischl B.R., Quinn B.T., Chong W.K., Gadian D.G., Lucas A. Impact of breast milk on intelligence quotient, brain size, and white matter development. Pediatr. Res. 2010;67:357–362. doi: 10.1203/PDR.0b013e3181d026da. - DOI - PMC - PubMed
    1. O’Connor D.L., Jacobs J., Hall R., Adamkin D., Auestad N., Castillo M., Connor W.E., Connor S.L., Fitzgerald K. Growth and development of premature infants fed predominantly human milk, predominantly premature infant formula, or a combination of human milk and premature formula. J. Pediatr. Gastroenterol. Nutr. 2003;37:437–446. doi: 10.1097/00005176-200310000-00008. - DOI - PubMed
    1. Belfort M.B., Anderson P.J., Nowak V.A., Lee K.J., Molesworth C., Thompson D.K., Doyle L.W., Inder T.E. Breast milk feeding, brain development, and neurocognitive outcomes: A 7-year longitudinal study in infants born at less than 30 weeks’ gestation. J. Pediatr. 2016;177:133–139. doi: 10.1016/j.jpeds.2016.06.045. - DOI - PMC - PubMed

Publication types

MeSH terms