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A Controlled-flow Vacuum-free Bottle System Enhances Preterm Infants’ Nutritive Sucking Skills

Abstract

We have shown that a controlled-flow vacuum-free bottle system (CFVFB) vs. a standard bottle (SB) facilitates overall transfer and rate of milk transfer, and shortens oral feeding duration in very-low-birth-weight (VLBW) infants. We aimed to understand the basis by which this occurs. Thirty infants (19 males; 27 ± 1 weeks gestation) were randomized to a CFVFB or SB. Outcomes monitored at 1–2 and 6–8 oral feedings/day when infants were around 34 and 36 weeks postmenstrual age, respectively, included: overall transfer (% volume taken/volume prescribed), rate of milk transfer (ml/min), sucking stage, frequency of suction (#S/s) and expression (#E/s), suction amplitude (mmHg), and sucking burst duration (s). At both periods we confirmed that infants using a CFVFB vs. SB demonstrated greater overall transfer and rate of milk transfer, along with more mature sucking stages. Suction and expression frequencies were decreased with CFVFB vs. SB at 1–2 oral feeding/day; only that of suction was reduced at 6–8 oral feedings/day. No group differences in suction amplitude and burst duration were observed. We speculate that oral feeding performance improves without significant change in sucking effort with a CFVFB vs. SB. In addition, we have shown that VLBW infants can tolerate faster milk flow than currently presumed. Finally, the use of a CFVFB may reduce energy expenditure as it enhances feeding performance without increasing sucking effort.

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Acknowledgments

The authors thank C. Scheel, MD, for his assistance in data collection, and E. O. Smith, PhD, and K. Fraley for their assistance in statistics. This project was supported by the National Institute of Child Health and Human Development (R01-HD28140; R01-HD044469) and the Fonds de la Recherche en Santé du Québec for a graduate student scholarship (SF). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health.

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Correspondence to Chantal Lau.

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Fucile, S., Gisel, E., Schanler, R.J. et al. A Controlled-flow Vacuum-free Bottle System Enhances Preterm Infants’ Nutritive Sucking Skills. Dysphagia 24, 145–151 (2009). https://doi.org/10.1007/s00455-008-9182-z

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Keywords

  • Bottle feeding
  • Oral feeding
  • Suck-swallow-breathe
  • VLBW
  • Prematurity
  • Deglutition
  • Deglutition disorders