A randomized crossover trial comparing the Nifty cup to a medicine cup in preterm infants who have difficulty breastfeeding at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana

Abstract

IntroductionPreterm infants make up the majority of the 9 million babies born in Africa and South Asia requiring supplemental feedings as they transition to exclusive breastfeeding. The World Health Organization recommends the use of a cup to feed newborns with breastfeeding difficulties in low-resource settings. We set out to evaluate the Nifty cup, a new feeding cup designed specifically for infants with breastfeeding difficulties.Materials and methodsWe conducted a randomized clinical trial in Ghana. We hypothesized infants would prefer the Nifty cup and that it would have less spillage as compared to a medicine cup. We enrolled mothers and preterm infants with breastfeeding difficulties indicated to cup feed at Komfo Anokye Teaching Hospital. Each mother-infant pair used the Nifty cup and a standard medicine cup; and two feeding assessments with each cup were conducted. We employed an intent-to-treat analysis comparing cup preference using a Wilcoxon signed rank test and spillage using generalized estimating equations.ResultsWe enrolled 200 mothers and 237 infants. Many infants were very low birth weight (62%), less than two weeks old (62%), and multiple birth (29%). In response to separate questions about each cup, more mothers reported liking the Nifty cup a lot as compared to the medicine cup (85% versus 57%, p<0.001). When asked to choose between the two cups, more than 75% preferred the Nifty cup (p < 0.001). There was slightly less spillage with the Nifty cup (8.9%) versus the medicine cup (9.3%), which was not statistically significant (p = 0.35). Mothers reported greater confidence and ease of using the Nifty cup and greater use one-month post-discharge compared to the medicine cup (p-values <0.001). Nearly all mothers were breastfeeding and cup feeding their infants at study initiation and at one-month post-discharge.DiscussionThis is the first randomized clinical trial of cup feeding in sub-Saharan Africa. Mothers prefer the Nifty cup to a medicine cup for supplemental feeds to their preterm infant. The Nifty cup was used with greater ease and confidence. The Nifty cup can offer an improved feeding experience for the mother-infant pair.

A Descriptive Study to Assess Level of Stress, Anxiety, and Pain Among Hospitalized Children Admitted in the Pediatric Surgery Unit of APC, PGIMER, Chandigarh 2020−2022

“…9 However, in previous studies, duration of feed and spillage were only measured qualitatively by asking mothers/caregivers. 10,11 It has also been suggested by previous research that if a neonate spends more than 20 min feeding, the energy expenditure increases, which can result in a decrease in weight gain. 12 In the present study, it was observed that the length of hospitalization was 13.0 ± 11.8 (1−77) days, and the PMA at discharge was 34 weeks.…”

Assessment of Duration of Feeding, Spillage, Weight Changes, Days to Reach Full Oral Feeds, Full Breastfeed, and Length of Hospitalization Among Preterm Neonates

“…9 However, in previous studies, duration of feed and spillage were only measured qualitatively by asking mothers/caregivers. 10, 11 It has also been suggested by previous research that if a neonate spends more than 20 min feeding, the energy expenditure increases, which can result in a decrease in weight gain. 12…”

Alimentação de recém-nascidos através da utilização do copo: revisão integrativa de literatura

“…Higienizado através de fervura em água por 10 minutos, autoclave ou desinfecção química. 13 Fonte: Autores Figura 4-Copo Dosador Padrão: Capacidade de 30 ml de volume, translúcido, marcado com escala de graduação, confeccionado em plástico comum, tipicamente usado para administrar medicamentos. 13 Fonte: Autores Figura 5-Copo Descartável: copo plástico de 50ml, não reutilizável, frequentemente indicado para consumo de café.…”

“…O aleitamento através do copo promove mais estímulos sensoriais e neuromotores ao lactente, bem como melhor capacidade de controle da ingestão de leite. 13 Pode ser utilizado por bebês prematuros, mesmo quando ainda não coordenam adequadamente as funções requeridas para mamar, já que a deglutição desenvolve-se precocemente na vida fetal em relação à coordenação com a sucção e a respiração. 14,15 Estudos com eletromiografia oral mostram que o copo, diferente dos dispositivos com bico artificial, aciona a musculatura mastigatória de forma semelhante à ordenha do peito, com maior movimentação da mandíbula e da língua.…”

“…4,16 Embora o copo apresente vantagens sob o aspecto fisiológico em relação a outros métodos alternativos, 4 a falta de familiaridade e a escassez de opções no mercado, fazem com que sua utilização seja bastante limitada. 13 Nesse contexto, o objetivo do presente estudo foi conhecer as evidências científicas acerca da alimentação de recém-nascidos com dificuldade de amamentação através de diferentes modelos de copos e, a partir disso, elencar as principais características que devem ser contempladas para o desenvolvimento de um dispositivo eficiente.…”