Cup-Feeding for Preterm Infants: Mechanics and Safety

Abstract

Cup-feedingis recommended for breastfed preterm infants to avoid artificial nipples. However, the oral mechanisms used in cup-feeding, or its safety and efficacy, have not been described. The authors measured sipping, breathing, Sa0 2,band volume of intake during15 cupfeeding sessions for 8 infants (mean gestational age at birthwas 30.6 weeks). Mean duration of sippingb ursts and pauseswas 3.6 seconds and 28.1 seconds, respectively. Mean breathingrate duringb ursts and pauses was similar (46.2 ± 24.3 vs 45.7 ± 17.7, respectively), with Sa02 = 90% duringall bursts. Mean duration of cup-feedings was 15.2 ± 3.9 minutes (range, 11.0-23.3), whereas mean volume of intake was only 4.6 ± 2.2 mL (range, 1.5-8). For the 15 sessions, 38.5% of milk taken from the cup was recovered on the bib. Although infants remain physiologically stable, cup-feeding has questionable efficacy and efficiency. Differentiating between actual intake versus spillage of milk merits attention.