Elastic sac to support oral feeding performance of preterm infants: Crossover randomized controlled study.

Background: Swaddling is recommended for preterm infants during feeding. Swaddling preterm infants with elastic cotton materials allows infants to easily stretch and move their extremities. This study aimed to assess the effect of bottlefeeding in a novel "elastic sac" on physiological parameters and feeding performance of preterm infants.

Methods: A randomized controlled, crossover trial was conducted with total of 26 preterm infants at 26-36 weeks of gestation. Infants randomly assigned to group 1 (n = 13) were bottlefed in an elastic sac (researcher-designed single-piece pouch made of soft, elastic cotton) for the first feeding and in normal clothes for the next feeding. Infants randomly assigned to group 2 (n = 13) were fed first in normal clothes and then in the elastic sac. The physiological parameters and feeding performance of the infants were assessed during each feeding.

Results: Preterm infants fed in the elastic sac had lower heart rate and higher oxygen saturation during and after feeding than infants fed in normal clothes (P < 0.05). Although all values were within clinically normal ranges, the findings suggest that feeding preterm infants in the elastic sac had a favorable effect on physiological parameters compared with feeding in normal clothes. There was no significant difference in the infants' feeding performance (P > 0.05).

Conclusion: A semielevated right lateral position and flexed body posture are recommended while feeding preterm infants, which can be easily maintained using the elastic sac. Feeding preterm infants in an elastic sac may support physiologic stability during oral feeding.