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Energy Expenditure in Breast and Bottle Feeding Preterm Infants Fed Their Mother's Breast Milk

Completed
Conditions
Preterm Infants
Interventions
Other: Way of Feeding - Breast feeding vs. Bottle feeding
Registration Number
NCT00838188
Lead Sponsor
Tel-Aviv Sourasky Medical Center
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

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
23
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

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
1Way of Feeding - Breast feeding vs. Bottle feedingcomputer-generated random numbers in sealed opaque envelopes to assign the breast/bottle sequence
2Way of Feeding - Breast feeding vs. Bottle feedingcomputer-generated random numbers in sealed opaque envelopes to assign the breast/bottle sequence
Breast - feeding firstWay of Feeding - Breast feeding vs. Bottle feedingcomputer-generated random numbers in sealed opaque envelopes to assign the breast/bottle sequence
Bottle firstWay of Feeding - Breast feeding vs. Bottle feedingcomputer-generated random numbers in sealed opaque envelopes to assign the breast/bottle sequence
Way of feedingWay of Feeding - Breast feeding vs. Bottle feedingEach infant is evaluated twice, once after breastfeeding and once after bottle feeding of breast milk using a Premature Nipple \& Ring (Ross Products Division, Columbus OH, USA). In this way, each infant serves as its own control. REE is recorded for 20 minutes after each meal
Primary Outcome Measures
NameTimeMethod
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 breast20 minutes after each meal
Secondary Outcome Measures
NameTimeMethod
Creamatocrit of the bottle at the beginning and the completion of every feeding at the breast were measuredNot relevant

Trial Locations

Locations (2)

Department of Neonatology, Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Sourasky Medical Center

🇮🇱

Tel-Aviv, Israel

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