Breast milk is the best source of nutrition for newborn babies, but what should be done if breastfeeding is not possible? A new Cochrane review in Issue 2 of The Cochrane Library for 2007 provides knowledge to answer this. The review found no advantage in terms of subsequent successful breast feeding for using a cup rather than a bottle.

If a newborn baby is unable to breast feed, they will need to be fed in some other way. This might be through a tube into their stomach, or with a bottle or a cup. An advantage suggested for cup feeding over using a bottle is that it will not introduce an artificial type of suckling to the baby, which might interfere with her ability to breastfeed later. However, cup feeding might also have disadvantages. The authors of the Cochrane review sought research that would help to identify the balance of the benefits and harms.

They searched for trials in which cup feeding was compared with some other type of feeding for babies who could not be breast fed. The content of the feed could be either expressed breast milk or formula feed, and the babies were to be less than four weeks old when entered into the trial.

Four trials were eligible for the review. All tested cup feeding versus bottle feeding, and all studied pre-term babies. The largest trial involved 319 infants, and the smallest studied 14. In total, 471 babies were included in the four trials.

The primary outcomes for the review related to breast feeding when the baby left hospital and over the subsequent months. When the results of the trials were combined in meta-analyses, there was no significant difference between the two methods of feeding on these outcomes, and any difference between cup feeding and bottle feeding seems likely to be small.

One of the aims of the Cochrane reviewers when they set out on their research was to evaluate the effectiveness and safety of cup feeding. They wanted to provide the knowledge that might help inform decisions about its introduction into neonatal nurseries. On the basis of what they found, they write that cup feeding cannot be recommended over bottle feeding as a supplement to breast feeding. They conclude that cup feeding confers no benefit in maintaining breast feeding after the baby leaves hospital, and that it may have the disadvantage of prolonging the time that she will stay in hospital before going home.

This Cochrane review is available in full at www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005092/frame.html.

Insider

May 21 2007