Oral feeding in premature infants: advantage of a self-paced milk flow

An earlier study demonstrated that oral feeding of premature infants (<30 w k gestation) was enhanced when milk was delivered through a self-paced flow system, The aims of this study were to identify the principle(s) by which this occurred and to develop a practical method to implement the self-paced system in neonatal nurseries. Feeding performance, measured by overall tra nsfer, duration of oral feedings, efficiency, and percentage of successful feedings, was assessed at three time periods, when infants were taking 1-2, 3-5, and 6-8 oral feedings/day. At each time period, infants were fed, seq uentially and in a random order, with a self-paced system, a standard bottl e, and a test bottle, the shape of which allowed the elimination of the int ernal hydrostatic pressure. Ln a second study, infants were similarly fed w ith the self-paced system and a vacuum-free bottle which eliminated both hy drostatic pressure and vacuum within the bottle. The duration of oral feedi ngs, efficiency, and percentage of successful feedings were improved with t he self-paced system as compared to the standard and test bottles. The resu lts were similar in the comparison between the self-paced system and the va cuum-free bottle. Elimination of the vacuum build-up naturally occurring in bottles enhances the feeding performance of infants born <30 wk gestation as they are transi tioned: from tube to oral feeding. The vacuum free bottle is a tool which c aretakers can readily use in neonatal nurseries.