The Effect of the SNS-Based Feeding on Transition to Exclusive Breastfeeding in Preterm Infants

The Effect of the Supplemental Nursing System-Based Feeding on Time to Transition to Exclusive Breastfeeding, Sucking Success, and Discharge Time: A Randomized Controlled Trial on Preterm Infants

This study investigated the effect of the Supplemental Nursing System (SNS)-based feeding on the time to transition to exclusive breastfeeding, sucking success, and the time to discharge in preterm infants

Nutrition is a critical problem in preterm infants. They should initially be enterally fed because they have poor sucking-swallowing-breathing coordination. Once a preterm infant develops that coordination, enteral feeding should be discontinued immediately. Then, the preterm should switch to oral feeding (breastmilk). However, preterm infants are not good at sucking because they get tired too quickly, have poor sucking skills, and lack enough experience. Therefore, we must use alternative supplemental feeding methods (bottle, spoon, dropper, cup, breastfeeding support system, and finger feeding) until preterm infants mature enough to meet their daily nutritional needs by breastfeeding alone (exclusive breastfeeding).

The Supplemental Nursing System (SNS) is an alternative supplemental feeding method that supports the development of sucking skills while providing the preterm infant's nutritional needs. This study investigated the effect of the Supplemental Nursing System (SNS)-based feeding on the time to transition to exclusive breastfeeding, sucking success, and the time to discharge in preterm infants.

Inclusion Criteria:

• being between the gestational ages of 30 to 34 weeks
• having a birthweight of ≥1000 g
• having an APGAR score of >6
• having stabilized for 48 hours after receiving mechanical ventilator or continuous positive air pressure or both
• being exclusively gavage-fed with breast and/or formula and ready to switch to oral feeding
• being willing to breastfeed

Exclusion Criteria:

• having a congenital malformation that may cause asphyxia and affect breathing
• having an intraventricular hemorrhage, intracranial hemorrhage, or periventricular leukomalacia
• having intestinal anomalies or hyperbilirubinemia requiring exchange transfusion
• having respiratory distress syndrome, bronchopulmonary dysplasia, or other chronic lung diseases.