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Aim: This study aimed to determine whether the Kumagai method could be followed by watching an instructional video and to compare the feeding actions of specialists and the general population. Materials and Methods: Eleven adults from diverse backgrounds were recruited and asked to feed a baby doll using a bottle feeder with a long nipple, and their actions were recorded. Then, they watched a 2.5-min instructional video of the Kumagai method and were asked to bottle-feed again. Video recordings of the participants were used to evaluate whether their actions followed the Kumagai method. Differences in the feeding actions of the specialists and participants were determined from still images in the videos. The McNemar test was used to analyze the differences between the participants' actions before and after. The Kruskal–Wallis test was also used to determine differences between the actions of participants and specialists. Results: Feeding movements significantly improved after watching the video. Participants' actions, which differed significantly from those of the specialists, were evident in "the angle of the nipple at the moment the nipple was brought close to the lips" and "the angle change of the nipple from the lip to the mouth". Conclusions: Watching our short instructional video was effective in improving the technique of the Kumagai method; however, it is insufficient for feeding a real child with cleft lip and palate. Including the rationale of each action in the video and adding direct instruction as a supplement is required. [ABSTRACT FROM AUTHOR]

Objective: Breastfeeding is the optimal source of nutrition for all infants, but there are limited data on feeding outcomes in infants with neonatal abstinence syndrome (NAS) who are admitted in the neonatal intensive care unit (NICU). Methods: A retrospective cohort study was conducted at a level II/III NICU. Study sample consisted infants with a diagnosis of NAS and those diagnosed with respiratory distress syndrome. The primary outcome was attainment of independent oral feeds, defined as the number of days to transition from full-tube to full oral feeds. Secondary outcomes included length of hospital stay and method (breast or bottle) of oral feeds at the start, at attainment of independent oral feeds, and at hospital discharge. Results: Infants with NAS took significantly longer to attain independent oral feeds than controls (P = .021) and received significantly fewer breastfeeds at the start of oral feeds, at independent oral feeds, and at hospital discharge (P = .000). There was no difference in length of hospital stay between groups. Conclusion: These results suggest that infants with NAS can experience difficulties achieving independent oral feeds and are less likely to receive breastfeeds. Additional support is required to enhance oral feeds in infants with NAS in the NICU. [ABSTRACT FROM AUTHOR]

The study aimed to examine the trends and associated factors of bottle-feeding among children aged 0–35 months. Data covering 11,205 mother-child pairs, from six recent Turkey Demographic and Health Surveys (TDHSs) were analyzed by using complex sample crosstabs and logistic regression. Bottle-feeding was on an upward trend from 33.0% to 51.5% from 1993 to 2013 and fell slightly 47.9% in 2018. Increasing trends of bottle-feeding were found in children aged 6–35 months, the East region, lower wealth index, maternal education under 5 years, Kurdish mothers, and the low antenatal care attendance. Multivariate analysis using data from TDHS-2018 showed that young maternal age, low birth weight and being 6–23 months of age were associated with higher rates of bottle-feeding. The prolonged bottle-feeding became widespread, and the bottle-feeding was common even in 35-month-old children. Interventions by the Government and stakeholders to minimize low rates of bottle-feeding should focus on high-risk groups. [ABSTRACT FROM AUTHOR]

Background: Problematic feeding is common in infancy, particularly in infants with a history of premature birth or medical complexity. A concise, valid, and reliable measure of feeding that can be used across feeding methods is needed for clinical practice and research. Purpose: The purpose of this study was to create an assessment tool to evaluate symptoms of problematic feeding in infants that can be used across all feeding methods (breastfeeding, bottle-feeding, and mixed feeding), then test its psychometric properties and establish reference values. Methods: Item response theory (IRT) was used to identify the most important items on the Neonatal Eating Assessment Tool (NeoEAT) related to symptoms of problematic feeding in infants (N = 1054) to create the Infant Eating Assessment Tool (InfantEAT). Reliability of the InfantEAT was tested using Cronbach's α and interitem correlations. Reference values of the InfantEAT were determined from a sample of healthy, full-term infants (n = 561). Percent agreement in identifying problematic feeding between the NeoEAT and the InfantEAT was calculated. Results: The InfantEAT is comprised of 31 items in 9 subscales. The InfantEAT has evidence of acceptable reliability (α = 0.88). There was 74% agreement between the NeoEAT and the InfantEAT, with the InfantEAT being more sensitive to identifying problematic feeding. References values are presented for infants 0 to 2, 2 to 4, 4 to 6, and 6 to 7 months. Implications Practice and Research: The InfantEAT is a reliable and sensitive tool to evaluate symptoms of problematic feeding across feeding methods for infants younger than 7 months in both practice and research. [ABSTRACT FROM AUTHOR]

Background: Mothers report feeling immense pressure to breastfeed their infants, and not doing so can be associated with stigma, shame, and judgment. Many Latina mothers struggle to meet their breastfeeding goals and substitute formula earlier than planned. During 2022, an infant formula recall caused a shortage and made acquiring formula difficult or impossible in many areas of the United States. This study explores Latina mothers' experiences with infant feeding during the time of the formula shortage. Methods: In-depth interviews (N = 7) were conducted with Latina mothers who formula-fed during the shortage. Interviews were analyzed using reflexive thematic analysis. Mean maternal age was 29.7 years, and mean infant age was 10.3 months. Three mothers were born in the United States, and 4 were immigrants. Results: Thematic analysis generated 3 themes: (1) Fighting to breastfeed; (2) Breastfeeding is not the only way to be a "good" mother; and (3) No formula on the shelves. Participants described their determination to continue breastfeeding despite challenges before realizing that it limited their ability to care for their children. They discussed the emotional toll of the formula shortage and strategies for finding formula. Conclusions: The findings emphasize the need for additional structural support for infant feeding in the United States to prevent future formula shortages and for better lactation care and mental health support for mothers who want to breastfeed. [ABSTRACT FROM AUTHOR]

To describe mothers' awareness and use of paced bottle-feeding (PBF) and to investigate whether the use of PBF was associated with maternal characteristics and infant feeding practices. Cross-sectional, online survey. Participants were mothers of infants < 12 months of age (n = 197). Participants self-reported their awareness and use of PBF, demographic characteristics, and infant feeding practices. Of the 41% of participants who indicated they had or maybe had heard of PBF, 23% used PBF and 35% sometimes used PBF. Use of PBF was not associated with mother or infant characteristics. Participants who used PBF were significantly less likely to encourage their infant to finish the bottle (odds ratio, 0.04; 95% confidence interval, 0.01–0.79). Paced bottle-feeding was associated with lower likelihood of one dimension of pressuring feeding practices, encouraging infant bottle-emptying. More research is needed to determine the effectiveness of PBF in promoting healthy feeding outcomes. [ABSTRACT FROM AUTHOR]

Bottle‐fed infants are at higher risk for rapid weight gain compared with breastfed infants. Few studies have attempted to disentangle effects of feeding mode, milk composition and relevant covariates on feeding interactions and outcomes. The objective of the present study was to compare effects of breastfeeding directly at the breast versus bottle‐feeding expressed breast milk on feeding interactions. Mothers with <6‐month‐old infants (n = 47) participated in two counterbalanced, feeding observations. Mothers breastfed their infants directly from the breast during one visit (breast condition) and bottle‐fed their infants expressed breast milk during the other (bottle condition). Masked raters later coded videos using the Nursing Child Assessment Parent–Child Interaction Feeding Scale. Infant intake was assessed. Mothers self‐reported sociodemographic characteristics, infant feeding patterns (i.e. percentage of daily feedings from bottles) and level of pressuring feeding style. Mother and infant behaviours were similar during breast and bottle conditions. Percent bottle‐feeding moderated effects of condition on intake (P = 0.032): greater percent bottle‐feeding predicted greater intake during the bottle compared with breast condition. Effects of feeding mode were not moderated by parity or pressuring feeding style, but, regardless of condition, multiparous mothers fed their infants more than primiparous mothers (P = 0.028), and pressuring feeding style was positively associated with infant intake (P = 0.045). Findings from the present study do not support the hypothesis that feeding mode directly impacts dyadic interaction for predominantly breastfeeding mothers and infants, but rather suggest between‐subject differences in feeding experiences and styles predict feeding outcomes for this population. [ABSTRACT FROM AUTHOR]

Background: Environment influences infant feeding decisions of mothers, which have influence on growth, development, health and nutrition of infants and children. Objectives: To assess the maternal knowledge and practices towards breast-feeding among mothers in Sohag. To correlate breast-feeding practices with maternal education, parity, mode of delivery, socioeconomic status and employment. Patients and methods: This cross-sectional study included 500 mothers of infants attending some primary health centers from 1st January to 30th November 2020. Data were collected using a self-administered standardized questionnaire. Results: Information present in this questionnaire were taken from 500 mothers, their information was founded to be taken from what friends (33%), media (10%) and primitives (57%). 52% of mothers knew that breast feeding was used as contraceptives. 63% of mothers agreed that babies breast fed naturally were healthier than those who breast feed artificially. 67%of mothers agreed that breast milk is useful but not satisfy the nutritional needs to sustain optimal growth beyond 6 months not due to decrease quality of breast milk but increased demand. Breast-feeding is related to educational level, parity, and socioeconomic status, in which (58%) and (80) of mothers had moderate educational level and moderate socioeconomic level respectively. Despite 61% of mothers disagree with the concept that they should stop nursing after only one year. Only 20% of them agreed to give bottle-feeding as complementary. Conclusion: It is really an encouraging observation that majority of the mothers had good knowledge and a positive attitude towards breast-feeding. Majority of the mothers fed the baby colostrum. Late initiation of breast-feeding has implications for health education programs and neonatal feeding strategies. [ABSTRACT FROM AUTHOR]

Conventional clear infant feeding bottles provide visual cues about the amount of milk consumed, which may decrease caregivers' sensitivity to infant cues, increase infant intake, and lead to greater infant weight gain. This study examined feasibility, adherence, acceptability, and preliminary effectiveness of an intervention in which families received clear vs opaque bottles. A pilot feasibility randomized controlled trial was conducted. Participants included mothers (N = 76) with young infants (2.9 ± 1.4 months old). Data collection occurred between December 2018 and July 2022 and within San Luis Obispo and Santa Barbara Counties, California. All assessments occurred within participants' homes. Participants were randomized to use clear (Clear group, n = 38) or opaque (Opaque group, n = 38) bottles for 12 weeks. We assessed feasibility of recruitment and retention, participant perceptions of study bottles, participant adherence to the intervention, maternal sensitivity to cues, infant intake (mL and mL/kg), and infant weight-for-length z -scores (WLZ). Data were analyzed using linear regression, χ2 analysis, and repeated-measures analysis of variance (ANOVA). Of 842 potential participants, 295 (35%) could not be reached after initial contact, 166 (20%) declined to participate, and 305 (36%) were ineligible. Of those who declined, 16 (10%) declined because they did not want to use study bottles. No differences were observed for loss to follow-up for Clear (8 of 38; 21%) vs Opaque (5 of 38; 13%) groups (P = 0.36) or for reported use of assigned bottles for Clear (89.8% ± 24.5% of daily feedings) vs Opaque (90.1% ± 22.1%) groups (P = 0.96). No group differences were observed for sensitivity to cues (P = 0.52) or intake (mL, P = 0.53 or mL/kg, P = 0.56) at follow-up. Opaque group infants had lower WLZ at follow-up compared with Clear group infants (mean difference, 0.47; 95% confidence interval, 0.08, 0.86; η p 2 = 0.17), adjusting for baseline WLZ. Relative to providing clear bottles, providing families with opaque bottles appeared feasible and acceptable, with good adherence. Although preliminary, study findings suggest the potential of opaque bottles to support healthier weight outcomes for bottle-fed infants. [ABSTRACT FROM AUTHOR]

Bottle‐feeding is an infant feeding modality that has been in existence since ancient times, and currently, a significant number of infants are being fed via a bottle with either breastmilk or formula. Although research on bottle‐feeding has continued, it exists in fragmented, often small studies that focus on singular aspects of feeding an infant using a bottle, with limited information on the bottle‐feeding act. Systems theory was the approach used to define the act of bottle‐feeding and identify the parts within this act. Health databases were searched using MeSH terms. A summary of the studies are included. The findings of this review revealed that healthy term bottle‐feeding infants use similar tongue and jaw movements, can create suction and sequentially use teat compression to obtain milk, with minimal differences in oxygen saturation and SSB patterns, when compared with breastfeeding infants. Bottle and teat characteristics were revealed to affect infant feeding and milk intake. An infant's milk intake during feeding was shown to have a strong association with the interaction between the infant and parent/caregiver. With the issue of who controls the feed, mother or infant, likely to affect an infant's ability to self‐regulate their milk intake. Redefining bottle‐feeding as a holistic system identifies the interrelationship of the various parts which will improve the understanding of the reciprocal nature of infant feeding. To optimize bottle‐feeding outcomes, further research is required on parents' and health professionals' knowledge and understanding of the parts within the act of bottle‐feeding. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to examine the prevalence of bottle feeding (BF) among children aged 0-23 months and factors associated with BF in Namibia.Methods: Data from Namibia 2013 Demographic Health Survey were used for the study. The study covered last-born alive children aged 0-23 months, making up 1926 mother-baby pairs. Chi-square tests and binary logistic regression were used to test for association between BF and related factors.Results: Prevalence of BF in Namibia was 35.7%. In the multivariate analysis, the following factors were significantly associated with increased risk of BF: working mothers, hospital delivery, increasing child age, higher mother's educational status, higher wealth quintile and urban residence.Conclusion: To achieve a substantial decrease in bottle usage rate in Namibia, breastfeeding promotion programmes should target all mothers but especially those at risk of BF highlighted in the study. [ABSTRACT FROM AUTHOR]

Background: Feeding difficulties are common in infancy. There are currently no valid and reliable parent-report measures to assess bottle-feeding in infants younger than 7 months. The Neonatal Eating Assessment Tool (NeoEAT)-Bottle-feeding has been developed and content validated.Purpose: To determine the factor structure and psychometric properties of the NeoEAT-Bottle-feeding.Methods: Parents of bottle-feeding infants younger than 7 months were invited to participate. Exploratory factor analysis was used to determine factor structure. Internal consistency reliability was tested using Cronbach α. Test-retest reliability was tested between scores on the NeoEAT-Bottle-feeding completed 2 weeks apart. Construct validity was tested using correlations between the NeoEAT-Bottle-feeding, the Infant Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R), and the Infant Gastrointestinal Symptoms Questionnaire (IGSQ). Known-groups validation was tested by comparing scores between healthy infants and infants with feeding problems.Results: A total of 441 parents participated. Exploratory factor analysis revealed a 64-item scale with 5 factors. Internal consistency reliability (α= .92) and test-retest reliability (r = 0.90; P < .001) were both excellent. The NeoEAT-Bottle-feeding had construct validity with the I-GERQ-R (r = 0.74; P < .001) and IGSQ (r = 0.64; P < .001). Healthy infants scored lower on the NeoEAT-Bottle-feeding than infants with feeding problems (P < .001), supporting known-groups validity.Implications For Practice: The NeoEAT-Bottle-feeding is an available assessment tool for clinical practice.Implications For Research: The NeoEAT-Bottle-feeding is a valid and reliable measure that can now be used in feeding research.Video Abstract Available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx. [ABSTRACT FROM AUTHOR]

Dominant discourses on breastfeeding as the optimal feeding method for infants and a way for mother and child to develop a strong bond are widely promoted and the message of ‘breast is best’ has been internalized by mothers around the world. Breastfeeding rates in Iceland and the other Nordic countries are among the highest in the world and the cultural and societal expectations for women to successfully breastfeed are therefore very high, as breastfeeding represents a strong moral and social norm. Iceland is considered a model for gender equality and feminism and this article thus examines the experiences of women who have struggled with breastfeeding, in a context which strongly promotes both breastfeeding and gender equality. By analysing the narratives of 77 Icelandic women, this article extends theorizing about rhetorical agency and resistance by demonstrating how they oppose and challenge dominant discourses on breastfeeding and good mothering and what counter-discourses they draw upon in order to make sense of their experiences. The findings indicate that feminism and feminist rhetoric have been unsuccessful in addressing and providing women with counter-discourses that challenge the highly gendered and oppressive elements of infant feeding and its link to idealized versions of motherhood. [ABSTRACT FROM AUTHOR]

Objective: To determine current status, areas for improvement and effect of conflict on infant and young child feeding (IYCF) practices among internally displaced persons (IDP) in eastern Ukraine.Design: Cross-sectional household survey, June 2015.Setting: Kharkiv, Dnipropetrovsk and Zaporizhia oblasts (Ukrainian administrative divisions) bordering conflict area in Ukraine.Subjects: Randomly selected IDP households with children aged <2 years registered with local non-governmental organizations. Questions based on the WHO IYCF assessment questionnaire were asked for 477 children. Mid-upper arm circumference was measured in 411 children aged 6-23 months.Results: Exclusive breast-feeding prevalence for infants aged <6 months was 25·8 (95 % CI 15·8, 38·0) %. Percentage of mothers continuing breast-feeding when their child was aged 1 and 2 years was 53·5 (95 % CI 43·2, 63·6) % and 20·6 (95 % CI 11·5, 32·7) %, respectively. Bottle-feeding was common for children aged <2 years (68·1 %; 95 % CI 63·7, 72·3 %). Almost all infants aged 6-8 months received solid foods (98·6 %; 95 % CI 88·5, 99·9 %). Mothers who discontinued breast-feeding before their infant was 6 months old more often listed stress related to conflict as their primary reason for discontinuation (45·7 %) compared with mothers who discontinued breast-feeding when their child was aged 6-23 months (14·3 %; P<0·0001).Conclusions: To mitigate the effects of conflict and improve child health, humanitarian action is needed focused on helping mothers cope with stress related to conflict and displacement while supporting women to adhere to recommended IYCF practices if possible and providing appropriate support to women when adherence is not feasible. [ABSTRACT FROM AUTHOR]

Objective: To explore longitudinal associations between bottle-feeding and maternal encouragement of infant bottle-emptying during the first 6 months of infancy.Design: Mothers completed questionnaires during the third trimester of pregnancy, then monthly during the first 6 months postpartum. Questionnaires assessed family demographics, maternal and infant weight status, infant feeding patterns and maternal encouragement of infant bottle-emptying.Setting: The Infant Feeding Practices Study 2, conducted by the US Centers for Disease Control and Prevention and the Food and Drug Administration.Subjects: Mothers (n 1776).Results: Repeated-measures regression was used to explore associations between bottle-feeding intensity (BFI; defined as the percentage of daily feedings that were from a bottle) and encouragement of bottle-emptying. Mothers who reported consistently high or consistently low BFI also exhibited consistently higher or lower frequency of encouraging their infants to empty the bottle (respectively) across the first 6 months of infancy, whereas mothers who reported increases in their BFI also exhibited concomitant increases in the frequency to which they encouraged their infants to finish the bottle. More frequent encouragement of bottle-emptying was also associated with feeding expressed breast milk (P<0·001), and lower parity (P=0·01), pre-pregnancy BMI (P=0·002) and infant birth weight (P=0·001).Conclusions: More frequent use of bottles for infant feeding was significantly associated with more frequent encouragement of bottle-emptying. Further research using causal designs is needed to better understand whether the use of bottles promotes this controlling feeding practice or whether mothers with more controlling feeding practices opt to bottle-feed. [ABSTRACT FROM AUTHOR]

In 2017, the field of lactation and breastfeeding support suffers from a bit of "halo adjusting" by a vocal few who, in the name of upholding the antipredatory marketing mandate of the International Code of Marketing of Breastmilk Substitutes (International Baby Food Action Network, n.d.), publicly and privately scold their colleagues for not sufficiently following the Code. Rather than generate better understanding of the Code, and how health workers can support breastfeeding families to meet optimal infant feeding goals, this "shame-and-blame" tactic drives health workers away from learning how better to uphold the Code (lest they suffer the slings and arrows of colleagues). [ABSTRACT FROM AUTHOR]

Background: The decision to introduce oral feeding (breast/bottle-feeding) in preterm infants is based on their weight, gestational age, physiological stability, and health status. Although the assessment based on these assumptions has been a clear asset, it has not always met preterm infants’ individual needs. Some instruments allow determining the adequate moment to begin oral feeding as well as monitoring the infantduring this process. Objectives: To perform the cultural adaptation and psychometric validation of the Early Feeding Skills Assessment,modified version (Early Feeding Skills Assessment, versãomodificada - EFS-VM). Methodology: Quantitative study with a sample of 698 newborns with a gestational age ≥24 and<37. Confirmatory factor analysis and Cronbach’s alpha were used to assess the factorial validity and reliability of the model. Results: The EFS-VM presented adequate factorial validity, ([χ2 (186)=913.206; p<.001, n=698; χ2 /df=4.91; CFI=.903; TLI=.890; RMSEA=.075; P[rmsea≤.05]<.001). Conclusion: EFS-VM is a sensitive, valid, and reliable tool to observe newborns’ early feeding skills; it facilitates the adjustment of the care plan, and allows developing interventions in partnership with families. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the extent to which mothers engage in distracting activities during infant feeding. Mothers reported engaging in other activities during 52% of feedings; television watching was the most prevalent activity reported. Further research on the impact of distraction on feeding outcomes is needed. [ABSTRACT FROM AUTHOR]

It is hypothesized that the visual and weight cues afforded by bottle-feeding may lead mothers to overfeed in response to the amount of liquid in the bottle. The aim of the present pilot study was to test this hypothesis by comparing mothers' sensitivity and responsiveness to infant cues and infants' intakes when mothers use opaque, weighted bottles (that remove visual and weight cues) compared to conventional, clear bottles to feed their infants. We also tested the hypothesis that mothers' pressuring feeding style would moderate the effect of bottle type. Formula-feeding dyads ( N  = 25) visited our laboratory on two separate days. Mothers fed their infants from a clear bottle one day and an opaque, weighted bottle on the other; bottle-order was counterbalanced across the two days. Infant intake was assessed by weighing each bottle before and after the feeding. Maternal sensitivity and responsiveness to infant cues was objectively assessed using the Nursing Child Assessment Feeding Scale. Mothers were significantly more responsive to infant cues when they used opaque compared to clear bottles ( p  = .04). There was also a trend for infants to consume significantly less formula when fed from opaque compared to clear bottles ( p  = .08). Mothers' pressuring feeding style moderated the effect of bottle type on maternal responsiveness to infant cues ( p  = .02) and infant intake ( p  = .03). Specifically, mothers who reported higher levels of pressuring feeding were significantly more responsive to their infants' cues ( p  = .02) and fed their infants significantly less formula when using opaque versus clear bottles ( p  = .01); no differences were seen for mothers who reported lower levels of pressuring feeding. This study highlights a simple, yet effective intervention for improving the bottle-feeding practices of mothers who have pressuring feeding styles. [ABSTRACT FROM AUTHOR]

The pattern of infant and young child feeding that provides the most benefit includes being put to the breast within an hour of birth, exclusive breastfeeding for 6 months, continued breastfeeding along with complementary foods up to 2 years of age or beyond, and avoidance of any bottle-feeding. However, since there are no published data from Kenya regarding trends in these feeding practices, this research undertook time trend estimation of these feeding practices using the 1998, 2003, and 2008-2009 Kenya Demographic and Health Survey and also examined the multivariate relationships between sociodemographic factors and feeding practices with data from 2008 to 2009. Logistic regression was used to test the significance of trends and to analyze sociodemographic characteristics associated with feeding practices. There was a significant decline in early initiation of breastfeeding among children in Central and Western provinces and those residing in urban areas. Trends in exclusive breastfeeding showed significant improvement in most sociodemographic segments, whereas trends in complementary feeding and breastfeeding remained stable. Bottle-feeding significantly decreased among children aged 12 to 23 months, as well as those living in Coast, Eastern, and Rift Valley provinces. In the multivariate analysis, the province was significantly associated with feeding practices, after controlling for child's size, birth order, and parity. The stagnant (and in some cases worsening) trends in early initiation of breastfeeding and complementary feeding with breastfeeding paint a worrisome picture of breastfeeding practices in Kenya; therefore, efforts to promote the most beneficial feeding practices should be intensified. [ABSTRACT FROM AUTHOR]

Very preterm (VP, ≤30 wk gestational age) infants are at risk for impaired lung function, which significantly limits their ability to eat. A semielevated side-lying (ESL) position is a feeding strategy that may improve oral feeding by supporting breathing during feeding. The study evaluated the efficacy of the ESL position compared with the semielevated supine (ESU) position on physiological stability and feeding performance of bottle-fed VP infants. Using a within-subject crossover design, 6 VP infants were bottle-fed twice on 1 day, in both the ESL and ESU positions in a random order. Physiological stability (heart rate, oxygen saturation [SaO2], and respiratory characteristics) and feeding performance (percent intake, proficiency, efficiency, and duration of feeding) were measured before and/or during feeding. Very preterm infants fed in the ESL position demonstrated significantly less variation in heart rate, less severe and fewer decreases in heart rate, respiratory rate that was closer to the prefeeding state, shorter and more regular intervals between breaths, and briefer feeding-related apneic events. No significant differences for SaO2 or feeding performance were found. The findings indicate that the ESL position may support better regulation of breathing during feeding, thereby allowing VP infants to better maintain physiological stability throughout feeding. [ABSTRACT FROM AUTHOR]

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Abstract: Objective: Coordinating sucking, swallowing and breathing to achieve effective sucking is a complex process and even though sucking is essential for nutrition, little is known about sucking patterns after birth. Our objective was to study sucking patterns in healthy fullterm infants and to describe the age-specific variations. Method: We studied the sucking patterns of 30 healthy, fullterm infants longitudinally from 2 or 3 days after birth to 10 weeks of age. During this time we recorded five to seven feeding episodes that we assessed off-line with the Neonatal Oral-Motor Assessment Scale (NOMAS). Results: We found a normal sucking pattern on the second or third day after birth in 27 out of 30 infants. During the following weeks we found abnormal sucking patterns in 23 out of 171 feeding episodes (14%) and normal patterns in 148 episodes (86%). Altogether, between 38 and 50 weeks’ postmenstrual age (10 weeks after birth), 10 infants displayed a deviating, arrhythmical sucking pattern. Dysfunctional sucking patterns and problems of coordinating sucking, swallowing and breathing did not occur. Birth weight, gestational age, type of labour and gender did not influence sucking patterns. Arrhythmical sucking was seen more often in bottle-fed infants. Conclusion: Our study demonstrated that practically all healthy fullterm infants started off with a normal sucking pattern soon after birth. One-third of the infants displayed one or more deviating episodes up to the age of 10 weeks. Apart from bottle-feeding, no other factors were found that influenced sucking patterns. [Copyright &y& Elsevier]

Aim: To obtain a better understanding of the changes in feeding behaviour from 1 to 6 months of age. By comparing breast- and bottle-feeding, we intended to clarify the difference in longitudinal sucking performance. Methods: Sucking variables were consecutively measured for 16 breast-fed and eight bottle-fed infants at 1, 3 and 6 months of age. Results: For breast-feeding, number of sucks per burst (17.8 ± 8.8, 23.8 ± 8.3 and 32.4 ± 15.3 times), sucking burst duration (11.2 ± 6.1, 14.7 ± 8.0 and 17.9 ± 8.8 sec) and number of sucking bursts per feed (33.9 ± 13.9, 28.0 ± 18.2 and 18.6 ± 12.8 times) at 1, 3 and 6 months of age respectively showed significant differences between 1 and 6 months of age (p < 0.05). The sucking pressure and total number of sucks per feed did not differ among different ages. Bottle-feeding resulted in longer sucking bursts and more sucks per burst compared with breast-feeding in each month (p < 0.05). Conclusion: The increase in the amount of ingested milk with maturation resulted from an increase in bolus volume per minute as well as the higher number of sucks continuously for both breast- and bottle-fed infants. [ABSTRACT FROM AUTHOR]

Objective:To study whether a cue-based clinical pathway for oral feeding initiation and advancement of premature infants would result in earlier achievement of full oral feeding.Study Design:Age of achievement of full oral intake was compared for two groups of preterm infants; a prospective study group vs historic cohort controls. Study infants had oral feedings managed by nurses using a clinical pathway that relied on infant behavioral readiness signs to initiate and advance oral feedings. Controls had oral feedings managed by physician orders.Result:Fifty-one infants (n=28 study and n=23 control) were studied. Gender distribution, gestational age, birth weight and ventilator days were not different between groups. Study infants reached full oral feedings 6 days earlier than controls (36±1 3/7 weeks of postmenstrual age (PMA) vs 36 6/7±1 4/7 weeks of PMA, P=0.02).Conclusion:The cue-based clinical pathway for oral feeding initiation and advancement of premature infants resulted in earlier achievement of full oral feeding.Journal of Perinatology (2007) 27, 572–578; doi:10.1038/sj.jp.7211791; published online 12 July 2007 [ABSTRACT FROM AUTHOR]

The rise in smoking rates among young women has implications for children’s health aggravated in lower social strata where infant morbidity and mortality rates are higher. The protection afforded by breastfeeding is beneficial to infants in rich and poor countries alike. Women (especially when young, uneducated, and unsupported) who are smokers constitute a risk group for abandoning breastfeeding; moreover, their bottle-fed newborns run a greater risk of morbidity and mortality. Bottle-feeding is attendant on maternal cigarette smoking. The advantages of breastfeeding over bottle-feeding are discussed with regard to systemic effects and the specific effects of cyanide (which can affect the iodine metabolism of infants) and nicotine derived from food and maternal smoking. Despite great strides in bans on smoking, public health policies should be designed to keep in perspective that breastfeeding is an effective tool to counterbalance the health disadvantages that under-privileged infants of smoking mothers face. This paper argues that infants born to smoking parents are better protected by breastfeeding than by formula feeding. Therefore, if public health policies cannot stop addicted mothers from smoking during pregnancy it is fundamental not to miss the chance of encouraging and supporting breastfeeding. The food and health inequalities of socially disadvantaged groups demand well crafted public-health policies to reduce the incidence of diseases and compress morbidity: these policies need to make it clear that breastfeeding is better and safer. [ABSTRACT FROM AUTHOR]

The article presents a study on the opposing effects of maternal and paternal socioeconomic status on neonatal feeding method, place of sleep, and maternal sleep time. This study recorded the time and method of feeding and sleeping in a log during the fourth-week postpartum. The record was analyzed according to the parental Hollingshead Index of Social Position in 33 families with their first newborn. It found socioeconomic status of the parents differentially affects neonatal care.

Aim: To determine the characteristics of primiparous women who breastfeed for only short periods of time. Methods: The 2002 National Survey of Family Growth was used to analyze the characteristics of a national probability sample of 3229 first-time US mothers aged 15 to 44 y with children ages 1 to 18 y old, 1960 of whom breastfed. Main outcome measures in the cross-sectional study included breastfeeding at birth and at 3 mo as determined by in-person, computer-assisted interviews conducted by trained female interviewers. Results: Sixty-two percent of first-time mothers with singleton live births initiated any breastfeeding and 36% were still breastfeeding at 3 mo. Those who were older, married, and at higher educational levels were significantly more likely to continue breastfeeding beyond 3 mo. These same demographic factors were associated with differences in breastfeeding rates both early (within the first week of life) and consistently over the first 3 mo. In multivariate analyses, only educational level remained as a predictor of breastfeeding. Conclusion: Targeted breastfeeding interventions for young, single, less-educated women are warranted in a culturally sensitive context, both prenatally and immediately postpartum, to improve the duration of breastfeeding among first-time mothers in the US. [ABSTRACT FROM AUTHOR]

Objective: To compare growth of infants fed goat milk infant formula (GMF) or cow milk infant formula (CMF) and to compare tolerability and safety of the two formulas. Methods: The study was conducted in Auckland, New Zealand. This was a double-blind randomized controlled trial. Newborn term infants were randomized within 72 h of birth to GMF or CMF. Milk formula powder in single serve sachets were reconstituted and fed to infants from trial commencement until age 168 days. No other formula given from randomization until age 168 days. Infant weight, length and head circumference were measured at birth and age 14, 28, 56, 84, 112, 140 and 168 days. Bowel motion frequency and consistency, sleeping and crying patterns and adverse events were also measured. Results: Seventy-two infants were randomized, 36 each to GMF or CMF, with 62 infants completing the intervention. At enrolment the average weight of infants in the GMF group (mean ± SD) was 3.33 ± 0.43 kg and in the CMF group 3.43 ± 0.47 kg; and at study completion 8.07 ± 0.90 kg (GMF) and 7.87 ± 0.99 kg (CMF). The difference in average weight gain over the study period for the GMF group versus the CMF group was not significant (+309 g; 95% CI = −49 to +668, P = 0.09). Median daily bowel motion frequency was greater in the GMF group than the CMF group (2.4 vs 1.7, P = 0.01). There were no group differences in bowel motion consistency, duration of crying, ease of settling, or frequency of adverse events. Conclusion: Growth of infants fed GMF is not different to that of infants-fed CMF. [ABSTRACT FROM AUTHOR]

OBJECTIVES:: To describe the first-week feeding patterns for breast- vs bottle-fed babies, and their association with sustained breast-feeding and infant weight gain at 6 weeks. DESIGN:: A longitudinal cohort study. SETTING:: Feeding diaries were completed by mothers in an urban UK community shortly after birth; follow-up weight and feeding data were collected at routine health checks. SUBJECTS:: Mothers of 923 full-term infants born during the recruiting period agreed to join the study. In all, 502 usable diaries were returned from 54% of the cohort. RESULTS:: Breast-fed infants were fed more frequently (2.71?h between feeds) than bottle-fed infants (3.25?h between feeds) and mixed-fed infants (3.14?h between feeds) (P<0.001) in the first week of life, while duration of feeds was similar. Only exclusive breast-feeding in the first week (P<0.001) and maternal education (P=0.004) were related to continued breast-feeding at 6 weeks. Greater first-week feeding frequency (as measured by feed-to-feed interval, h) was associated with higher weight gain at 6 weeks for breast-feeders, but no analysed factors were associated with higher weight gain for bottle-feeders. CONCLUSIONS:: This large-scale study of first-week feeding patterns sheds light on the important and complicated issues of breast-feeding continuation and infant weight gain, with implications for the feeding advice given to mothers. Supplementary bottle feeds were clearly associated with discontinued breast-feeding at 6 weeks. Over that period, higher weight gain was associated with more frequent feeding for breast-fed infants only. SPONSORSHIP:: Henry Smith Charity, SPARKS, Child Growth Foundation.European Journal of Clinical Nutrition (2004) 58, 1290-1296. doi:10.1038/sj.ejcn.1601964 Published online 31 March 2004 [ABSTRACT FROM AUTHOR]

Bottle-fed infants are at greater risk for overfeeding and rapid weight gain (RWG); evidence-based strategies for promoting healthy bottle-feeding practices are needed. Our aim was to assess whether policy, systems, and environmental (PSE) strategies for promoting responsive bottle-feeding practices within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were associated with lower risk for RWG. We conducted a matched-pair cluster randomized trial. PSE strategies were implemented at 3 WIC clinics in Los Angeles County. PSE clinics were compared with 3 matched control clinics. Mothers and infants were assessed when infants were newborn and 3 months and 6 months of age. Participants were mothers (n = 246) who enrolled their newborn infants (younger than 60 days) into WIC between May and August 2019. Infant weight was assessed and standardized to sex- and age-specific z scores. RWG was defined as weight-for-age z score change > 0.67. Mothers completed questionnaires assessing responsive and pressuring feeding styles, breast- and bottle-feeding patterns, and perceptions of WIC experiences. Logistic regression with estimation via generalized estimating equations and linear mixed models with repeated measures assessed effects of PSE strategies on categorical and continuous outcomes, respectively. Infants in PSE clinics had significantly lower likelihood of exhibiting RWG (P =.014) than infants in control clinics. Mothers in PSE and control clinics reported similar levels of responsive and pressuring feeding style and similar prevalence of breastfeeding and bottle-feeding. Mothers in PSE clinics trended toward feeling better supported with respect to their decision to bottle-feed (P =.098) and had more stable intentions to stay in the WIC program (P =.002) compared with mothers in control clinics. PSE strategies focused on promoting more inclusive assessment of infant feeding, tailored bottle-feeding counseling, and increased education and support for responsive bottle-feeding were associated with lower risk for RWG among WIC infants. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the immediate and long-term effects of type of infant diet (formula-fed vs. breast-fed) on the weight growth of baboons. Longitudinal (serial) weight data were collected from 44 savannah baboons (Papio cynocephalus anubis) for the total preadult period of growth from birth to approximately 8 years of age. Fifty percent of the sample (11 females and 11 males) were fed a standard infant formula by a nursery care technician for the first 18 weeks of postnatal life. The remaining 11 females and 11 males were breast-fed by their mothers for an equivalent period of time. After 18 weeks of age the animals were removed from their infant environments (either nursery or mother-reared) and assigned to one of four age-cohort social groups. Each age-cohort group was balanced for infant treatment and gender. The animals remained in these social groups for the duration of the project and were provided nutritionally identical postweaning diets. No significant weight differences were found between the two rearing conditions for either gender during the initial 15 weeks of growth. Following this period, however, females of breast-fed environments averaged greater weight at all ages than their bottle-fed peers. The intensity of the adolescent growth spurt was also slightly greater among the female breast-fed group. No postinfant avenge weight-per-age disparity was observed between the male treatment groups. [ABSTRACT FROM AUTHOR]

Production of γ-interferon (7-IFN) in vitro by peripheral blood mononuclear cells (PBMC) from 15 breast-fed and 15 bottle-fed infants has been studied from birth lo 9 months of age and compared with production by adult cells. Using a Terasaki plate microculture system with serum-free medium, PBMC were stimulated with staphylococcal enterotoxin A (SEA) and γ-IFN production was assessed by an immunoradiometric assay. Cord blood mononuclear cells (CBMC) and PBMC from all infants secreted large quantities of γ-IFN. The levels secreted did not change significantly with age over the 9 months of the study, nor did they differ from the levels secreted by adult cells. Cells from the bottle-fed infants secreted slightly more γ-IFN than cells from breast-fed infants, but this difference was not significant. These results indicate that the potential for PBMC to secrete -γ-IFN in vitro is fully developed at birth in full-term infants and cannot therefore be further influenced by subsequent breast- or bottle-feeding. In addition, the greater susceptibility of infants than adults to certain bacterial and viral infections cannot be attributed to a deficiency in the potential of infant cells to secrete γ-IFN in vitro. . [ABSTRACT FROM AUTHOR]

Caregivers' abilities to assess how much is in the bottle may lead to encouragement of infant bottle emptying and overfeeding. The present study assessed whether use of opaque, weighted bottles (as compared with conventional, clear bottles) improves feeding outcomes. Mothers with infants <32 weeks of age (n = 76) were assessed on two separate days. Mothers fed their infants from an opaque, weighted bottle on 1 day and a clear bottle on the other; conditions were counterbalanced. Blinded raters certified in the Nursing Child Assessment Feeding Scale scored all videos to determine maternal sensitivity. Infant intake was assessed by weighing the bottle before and after each feeding, and feeding outcomes included infant intake (mL), intake per kilogram body weight (mL/kg), meal duration (min), and feed rate (mL/min). Mothers exhibited significantly greater sensitivity (p = 0.041), fed their infants fewer millilitres per kilogram body weight (p = 0.049), and fed their infants at a significantly slower rate (p = 0.009) when using opaque compared with clear bottles. Infant clarity of cues was a significant moderator of effects of bottle type on intake per kilogram body weight (p = 0.028): Infants who exhibited greater clarity of cues were fed less during the opaque versus clear conditions whereas infants who exhibited poorer clarity of cues were fed similar amounts during both conditions. Effects of bottle type were not moderated by bottle contents (expressed breast milk vs. formula). In sum, promotion of opaque, weighted bottles for infant feeding may be a pragmatic approach to improve the quality and outcome of bottle‐feeding interactions. [ABSTRACT FROM AUTHOR]

An abstract of the article "Do Infants Fed From Bottles Lack Self-regulation of Milk Intake Compared With Directly Breastfed Infants?," by Ruowei Li, Sara B. Fein, and Laurence M. Grummer-Strawn is presented.