BREAST-FEEDING OF VERY-LOW-BIRTH-WEIGHT INFANTS

Twenty very low birth weight infants (birth weight < 1500 gm) were ass essed to compare the clinical effects of breast and bottle feedings. T he infants started breast-feeding during the same week that they start ed bottle feedings. Five breast-feedings and five bottle feedings for each infant were observed. Axillary temperature and weight before and after feedings were measured, and oxygen saturation, respiratory rate, and heart rate were monitored and recorded every 2 minutes during the feeding periods. The results showed no difference in oxygen saturatio n during breast-feeding (p = 0.056) but a lower incidence of oxygen de saturation (< 90%) (21% vs 38% in breast-feeding vs bottle feeding, re spectively; p < 0.025). Infants with bronchopulmonary dysplasia had hi gher oxygen saturation during breast-feeding than during bottle feedin g (p < 0.025), but weight gain during breast-feeding sessions was less (median, no gain vs 31 gm, p < 0.001). We conclude that (1) very low birth weight infants can tolerate both breast and bottle feedings at t he same postnatal age; (2) very low birth weight infants are less like ly to have oxygen desaturation to less than 90% during breast-feeding; and (3) weight gain is less during breast-feeding, probably because o f lower intake, and may require more lactation counseling or supplemen tation of the feedings.