Cup-feeding Preterm Infants
by Anne Eglash MD, IBCLC, FABM
Preterm infants are more vulnerable to morbidity and mortality than term infants, but they have lower breastfeeding rates at hospital discharge. Although most preterm infants in the USA are discharged bottle feeding to some extent, evidence and clinical experience has taught us that bottle feeding may be associated with breast refusal in this population. Although one may argue that with enough perseverance, a preterm infant will eventually breastfeed, many families are doubtful and stressed by the work involved in transitioning to the breast. Many mothers of preterm infants in the USA become exclusive pumpers, which is associated with early weaning..
According to a 2018 literature review of cup feeding as an alternative method for oral feeding, cup feeding and other similar feeding vessels have been used for many years by several populations world-wide to feed preterm infants. Preterm infants are able to cup feed by 30 weeks gestation, earlier than they are able to bottle feed.
This literature review included 12 peer-reviewed research studies on the use of cup feeding among preterm infants, with 7 being randomized controlled trials. The studies represented populations in the USA, UK, India, Turkey, Australia, Egypt and Brazil.
- Cup feeding was found to be slower than bottle feeding.
- Infants who were cup fed had stable oxygen saturations and heart rates.
- Cup feeding was associated with a longer duration of stay in the NICU.
- Cup feeding was associated with a higher rate of exclusive breastfeeding at discharge.
- Cup feeding was associated with a higher rate of aspiration and pneumonia.
Sharon Leavitt RN IBCLC
Thank you for this review of existing research. I often recommend cup feeding to mom’s who are having difficulty getting an infant to breast. I often meet moms who are coming out of our local hospitals with nipple shields and /or pump dependent. It is nice to have the research to support the use of cup feeding to help establish breastfeeding when the infant needs supplementation and breastfeeding has not gone well in the beginning.