BREAST-FEEDING INFANTS WHO WERE EXTREMELY LOW-BIRTH-WEIGHT

Objective. To compare the clinical effect of breastfeedings and bottle feedings in extremely low birth weight (ELBW) infants (birth weight 8 00 g). Methods. A total of 12 ELBW infants (mean birth weight, 672 +/- 95 g; mean gestation, 26 +/- 2 weeks) served as their own controls in this prospective study comparing physiologic parameters during bottle and breastfeeding. The infants were put to breast the same week they began on bottle feedings of human milk or premature infant formula (me an gestation, 35 weeks). One breastfeeding and one bottle feeding were observed each day for 10 days. Pre-and postfeeding weights were measu red, and oxygen saturation, respiratory rate, heart rate, and axillary temperature were monitored continuously and recorded every minute dur ing feedings. Results. The infants demonstrated a higher oxygen satura tion and a higher temperature during breastfeeding than during bottle feeding, and were less likely to desaturate to <90% oxygen during brea stfeeding. Mean weight gain was greater during bottle feeding than dur ing breastfeeding (31 vs 9 g). Conclusions. Breastfeeding the ELBW inf ant is desirable from a standpoint of improved physiologic responses, but such practice requires breastfeeding support and possible suppleme ntation to optimize weight gain.