637 - Reference Values for Sucking Pressure Waveforms in Bottle-Fed Newborns: Establishing Norms for Clinical Assessment

Publication Number: 637.6468

Kensuke Kumazawa, The Jikei University School of Medicine, Tokyo, Tokyo, Japan; Saya Yamada, The Jikei University School of Medicine, Tokyo, Tokyo, Japan; Daishi Hirano, The Jikei university school of medicine, Ohta-ku, Tokyo, Japan; Kimihiko Oishi, The Jikei University School of Medicine, MInato-ku, Tokyo, Japan

Background: Globally, 59% of infants are bottle-fed, with bottle dependency notably higher among preterm infants. Transitioning between bottle and breastfeeding poses challenges due to mechanical and sensory differences, leading some infants to struggle with adequate feeding and nutrition. These issues highlight the need for objective assessment methods, yet it is crucial to assess feeding mechanics during bottle-feeding objectively. However, a standardized approach for evaluating feeding mechanics has not been established.

Objective: This study aimed to measure the sucking pressure waveform of healthy, full-term newborns during bottle feeding using a novel device to establish reference values for key parameters.

Design/Methods: The study included full-term infants without external malformations or congenital abnormalities. Sucking pressure was measured using a custom device with a silicone-tipped artificial nipple and a semiconductor pressure transducer while feeding each infant 20 ml of milk on the second day after birth. Key parameters, including maximum sucking pressure, duration per suck, and number of pauses (breaks >2 seconds) during 20ml feeding, were extracted from the waveform. The feeding rate and volume per suck were calculated based on the total feeding time. The 95% reference interval was determined using mean and standard deviation values.

Results: Data from 26 newborns (gestational age: 40 ± 1 weeks; birth weight 3,169 ± 335 g) showed maximum sucking pressure of -157 ± 31 mmHg, duration per suck of 0.88 ± 0.13 seconds, number of pouses of 3 ± 4 times, feeding rate of 6.75 ± 1.81 ml/min, and volume per suck of 0.11 ± 0.04 ml. Reference ranges were established: maximum sucking pressure; -170 to -145 mmHg, duration per suck; 0.81 to 0.92 sec, pauses per 20ml feeding; 1.5 to 4.0 times, feeding rate; 6.02 to 7.48 ml/min, and volume per suck; 0.09 to 0.13 ml.

Conclusion(s): This study established reference values for key parameters in bottle-fed, full-term newborns. Applying these measurements to newborns with feeding difficulties could help identify specific challenges in their suckling, enabling targeted interventions.