Cup-feeding for low-birth-weight infants unable to fully breastfeed
Every year, more than 20 million infants are born weighing less than 2500 g – over 96% of them in developing countries. These low-birth-weight infants are at increased risk of neonatal morbidity and mortality.
WHO recommends that low-birth-weight infants should be fed mother's own milk. If these infants cannot be fed mother's own milk, they should be fed donor human milk (in settings where safe and affordable milk banking facilities are available or can be set up) or standard infant formula.
Low-birth-weight infants who are unable to breastfeed can be fed by alternative oral feeding methods such as bottle-feeding or cup-feeding. Studies comparing these methods have shown that cup-feeding improves exclusive breastfeeding rates at discharge but these benefits are not sustained. Cup-feeding is also associated with prolonged hospital stays. However, as cups are easier to clean than bottles, cup-feeding could potentially reduce the risk of severe infections such as diarrhoea.
WHO therefore recommends that low-birth-weight infants who need to be fed by an alternative oral feeding method should be fed by cup (or palladai, which is a cup with a beak) or spoon.
Systematic reviews used to develop the guidelines
Related Cochrane reviews
- Avoidance of bottles during the establishment of breast feeds in preterm infants
- Cup-feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed