Breastfeeding and Supplementary Oral Feeding Methods in Very Preterm Infants: A Prospective Within-Infant Comparison.

Authors

Ayşe Gökçe Kutsal, Nilgün Altuntaş

Published in

Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine. Pages 15568253261492467. Sep 28, 2026. Epub Sep 28, 2026.

Abstract

Very preterm infants often require supplementary oral feeding while direct breastfeeding skills mature. We compared short-term feeding performance and suck-swallow-breath coordination (SSBC) across three oral feeding methods.
In this prospective within-infant study, 30 clinically stable infants born at <32 weeks' gestation were evaluated at ≥34 weeks' corrected gestational age. Each infant underwent three routinely scheduled feeds approximately 3 hours apart: direct breastfeeding, syringe-assisted finger feeding, and feeding with one specific slow-flow NaturalWave^® bottle. Feeding order was systematically counterbalanced. SSBC was assessed during standardized 2-minute NeoSAFE recordings. Milk transfer, achievement of prescribed feeding volume, duration, spillage, and physiological observations were recorded.
Exploratory analyses detected no statistically significant differences in NeoSAFE-derived SSBC parameters. Apnea events were infrequent; no statistically significant pairwise differences were detected for apnea or desaturation. The full prescribed volume was achieved in 2/30 breastfeeding sessions and 28/30 sessions with each supplementary method. Breastfeeding had lower measured milk transfer and the least spillage. The bottle and syringe-assisted finger feeding each achieved the full prescribed volume in 28/30 sessions; the bottle showed numerically faster intake than syringe-assisted finger feeding without a statistically significant difference. Heart rate differences were observed between methods, but their clinical significance was uncertain.
The methods differed in short-term volume-delivery characteristics. Absence of statistically significant SSBC differences does not establish equivalence. Bottle findings are product-specific and do not address breastfeeding initiation, exclusivity, or duration. Randomized trials are needed to evaluate long-term breastfeeding outcomes.

PMID:
42802919
Bibliographic data and abstract were imported from PubMed on 28 Sep 2026.

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