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Abstract
Milk flow achieved during feeding may contribute to the ventilatory depression observed
during nipple feeding. One of the important determinants of milk flow is the size
of the feeding hole. In the first phase of the study, investigators compared the breathing
patterns of 10 preterm infants during bottle feeding with two types of commercially
available (Enfamil) single-hole nipples: one type designed for term infants and the
other for preterm infants. Reductions in ventilation, tidal volume, and breathing
frequency, compared with prefeeding control values, were observed with both nipple
types during continuous and intermittent sucking phases; no significant differences
were observed for any of the variables. Unlike the commercially available, mechanically
drilled nipples, laser-cut nipple units showed a markedly lower coefficient of variation
in milk flow. In the second phase of the study, two sizes of laser-cut nipple units,
low and high flow, were used to feed nine preterm infants. Significantly lower sucking
pressures were observed with high-flow nipples as compared with low-flow nipples.
Decreases in minute ventilation and breathing frequency were also significantly greater
with high-flow nipples. These results suggest that milk flow contributes to the observed
reduction in ventilation during nipple feeding and that preterm infants have limited
ability to self-regulate milk flow.