BREAST-FEEDING IMPROVES PHYSIOLOGIC STATES OF EXTREMELY-LOW-BIRTH-WEIGHT(ELBW) INFANTS (≤800 gms). † 598

Although breast-feeding (BF) has known beneficial effects for VLBW infants, it is unknown whether it is physiologically safe for the micropremie. 12 ELBW infants (mean b.wt.: 672±95 gms; mean gest: 26.5±2 wks) served as their own controls in a prospective study comparing physiologic parameters during breast and bottle feeding (BoF). It was hypothesized that ELBW infants would be physiologically more stable during BF. The infants were put to breast the same week that they were begun on BoF of human milk (mean gest age: 35±2 wks). 1 BF and 1 BoF were observed each day for 10 days. Pre and post feeding wts were measured, and oxygen saturation (O₂ sat), respiratory rate (RR), heart rate (HR) and axillary temperature (temp) were continuously monitored and recorded every minute during feedings. 100% of the BFs and 94% of the BoFs observed were ≥6 minutes long. Results show higher 0₂ sat and higher temp during BF than during BoF as shown:Figure Of the 510 0₂ sat recordings during BF, 47(9%) were <90%, whereas of the 506 recordings during BoF, 101 (20%) were<90% (p<.001). There was no difference in RR or HR. Mean wt gain was greater during BoF than BF (31 vs 9 gms p<.001). Thus, ELBW infants maintain a higher 0₂ sat and higher temp during BF and are less likely to desaturate to <90% 0₂. Intake as reflected in wt gain, however, is less during BF. We conclude that BF the micropremie is desirable from a standpoint of improved physiologic responses, but such practice will require supplementation to optimize wt gain.

Figure 1