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Preterm neonates need an alternative method of feeding before breastfeeding. : To compare the Nifty cup with Katori-spoon feeding in preterm neonates on full gavage feeds and deemed fit for oral feeding.This open-label, parallel, randomized controlled trial will be done at the step-down unit of a tertiary care center in Northern India. We will include preterm neonates (< 34 weeks gestation) on gavage feeds. Our primary outcome will be the time taken to achieve full oral feeds (defined as 150 mL/kg/day) and the duration of the feeding transition. The secondary outcomes will be time to attain full breastfeeds, time spent during the feeding sessions, spillage of feeds, adverse events (including mortality), anthropometry (weight, length, occipitofrontal circumference) at discharge, and duration of hospitalization.We will also take the opinion of mothers/caregivers and nurses on Nifty cup use by the use of an indigenously designed questionnaire. We will need 94 participants to detect a significant difference of 3 days in transition duration with 5% α error and 80% power. To account for non-compliance/crossover, we will enroll 106 participants (53 in each group).We will do intention to treat analysis. All data will be analyzed using SPSS version 23 statistical software for Windows. We will do a regression analysis to determine if the intervention is an independent predictor of time to full oral feeds after adjusting for pre-specified variables like gestational age, birth weight, and PMA at enrolment.The study will provide evidence on the best feeding method for feeding preterm neonates. This evidence will guide nurses/health care professionals in deciding the feeding method for preterm infants.

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Background Preterm neonates are not able to breastfeed due to immature sucking swallow reflexes and are kept on an alternative method of feeding until they are able to do so. The time to reach full oral feeds and breastfeed, the duration of feeding, and spillage are important parameters that need to be observed so that a baseline value can be provided, which can help healthcare professionals see the progression and appropriateness of feeding preterm neonates. Objective To assess the duration of feeding, spillage, weight changes, days to reach full oral feeds, full breastfeed, and length of hospitalization among preterm neonates. Material and Methods A descriptive study was carried out on 106 preterm neonates in the step-down unit of the NICU, PGIMER, Chandigarh. The variables under study were duration of feeding, spillage, weight changes, days to reach full oral feeds, days to reach full breastfeed, and length of hospitalization. The tools for data collection used were a socio-demographic profile along with a clinical profile of neonates, a neonatal assessment, and an observation sheet to record spillage and duration of feeding. The methods of data collection used were observation and biophysiological methods. Weight was assessed by the infant weighing scale present in the unit (in grams) and to measure spillage, a bib was used, and its pre- and post-feeding weight was measured on a diaper weighing machine. The values are expressed in grams. The data were collected from July 2021 to November 2021. The data are analyzed using the SPSS version 23.0. Results The results showed that neonates took an average of mean ± SD (range) 15.0 ± 3.12 (10−26) min to complete one feeding session, and spillage was around 1.37± 0.3 (0.8−2.3) g. The transition time to full oral feeds was 8.01 ± 7.21 (1–44) days, and the average time to reach full breastfeed was 26.7 ± 12.1 (5−56) days. Conclusion The present study has provided valuable data on duration of feeding and spillage that serves as a guide for the amount of milk that can be added to the prescribed feed. The information is also helpful in educating the parents to be patient while feeding the baby and wait for at least 3 weeks to 2 months to reach full breastfeed. Gestational age at birth and birth weight affect (negative correlation) the time to reach full oral feeds, breastfeed, and length of hospital stays ( p < .05).