Objective. To compare the clinical effect of breastfeedings and bottle feedings in extremely low birth weight (ELBW) infants (birth weight ≤800 g).

Methods. A total of 12 ELBW infants (mean birth weight, 672 ± 95 g; mean gestation, 26 ± 2 weeks) served as their own controls in this prospective study comparing physiologic parameters during bottle and breastfeeding. The infants were put to breast the same week they began on bottle feedings of human milk or premature infant formula (mean gestation, 35 weeks). One breastfeeding and one bottle feeding were observed each day for 10 days. Pre- and postfeeding weights were measured, and oxygen saturation, respiratory rate, heart rate, and axillary temperature were monitored continuously and recorded every minute during feedings.

Results. The infants demonstrated a higher oxygen saturation and a higher temperature during breastfeeding than during bottle feeding, and were less likely to desaturate to <90% oxygen during breastfeeding. Mean weight gain was greater during bottle feeding than during breastfeeding (31 vs 9 g).

Conclusions. Breastfeeding the ELBW infant is desirable from a standpoint of improved physiologic responses, but such practice requires breastfeeding support and possible supplementation to optimize weight gain.

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