By Working Harder, Preemies Can Learn to Bottle Feed Better

Premature infants may learn to bottle-feed better if nurses and others make them work a little for their meals. As a result, the infants might "graduate" sooner from the hospital and get to go home, according to scientists at the Children's Nutritional Research Center in Houston, Texas.

The center is a cooperative venture of USDA's Agricultural Research Service and Baylor College of Medicine.

Typically, preemies start out getting all their nutrition intravenously. When they switch to a bottle, it's usually held vertically so gravity does all the work. But the practice of tilting the bottle less has been catching on with some neonatal and newborn intensive care units.

Scientists at the Houston center wanted to test whether giving a baby more control actually would help teach the sucking, breathing and swallowing skills necessary for going home. So they rigged some bottles with a special catheter to monitor whether the infants were learning these skills. Then they hooked the bottles to a machine that measured the infants' sucking and swallowing.

They gave the preemies milk in the traditional, gravity-flow way and with a more horizontal bottle. When infants had to work a bit for their milk, scientists found they drank a greater amount per unit of time.

Another advantage of less tilting: infants can control their intake. Otherwise, they can't pace themselves. They may get their milk too quickly or more than they want at one time.

The monitoring device may also help neonatolgists--pediatricians who deal with newborns--evaluate how well their patients are progressing. Doing well with the "bottle challenge" is a good sign that an infant's other motor functions are developing nicely.

Scientific contact: Robert Shulman, USDA/ARS Children's Nutritional Research Center at Baylor College of Medicine, Houston, TX 77030. Phone: (713) 798-7145, Fax: (713) 798-7171. rshulman@bcm.tmc.edu.