NEW YORK (Reuters Health) – New research indicates that breastfeeding requires no more (or less) resting energy expenditure (REE) than bottle-feeding in preterm infants. This finding runs counter to the research team’s hypothesis that breastfeeding would require more REE.

In light of this finding, Dr. Shaul Dollberg and colleagues, from Tel Aviv Sourasky Medical Center, Israel, conclude that it is probably safe to recommend breastfeeding for preterm infants (born at >32 weeks) once they tolerate oral feeding.

The findings, reported in the December issue of Pediatrics, stem from a study of 19 preterm infants (at least 32 weeks gestational age) who were nourished entirely with their mothers’ breast milk and were randomized to receive the milk either directly from the breast or from a bottle. After one feeding with the assigned method, the infants then fed with the other method.

REE was assessed for 20 minutes after each type of feeding using standard methods, the report indicates.

The average REE after breastfeeding was comparable to that after bottle-feeding: 282.6 vs. 284.7 kJ/kg/day. Moreover, this held true even though it took roughly 12 minutes longer to breastfeed (20.1 vs. 7.8 minutes, p < 0.0001). “The fact that the mechanics of sucking and swallowing at the breast are significantly different from those with artificial nipples, as demonstrated with ultrasonography, and the longer duration of feeding at the breast led us to hypothesize that REE values also would be different,” the authors explain. However, this was not the case. “We speculate,” they continue, “that allowing infants to feed at the breast as soon as they can tolerate feedings by mouth would not jeopardize energy balance and has manifold nutritional, physiologic, and emotional benefits.” Reference:
Pediatrics 2009;124:e1149-e1152.