title: Effect of bottles, cups, and dummies on breast feeding in preterm infants: a randomised controlled trial.
abstract: OBJECTIVE
  To determine the effect of artificial teats (bottle and dummy) and cups on breast feeding in preterm infants.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Two large tertiary hospitals, 54 peripheral hospitals.
  
  
  METHODS
  319 preterm infants (born at 23-33 weeks' gestation) randomly assigned to one of four groups: cup/no dummy (n = 89), cup/dummy (n = 72), bottle/no dummy (n = 73), bottle/dummy (n = 85). Women with singleton or twin infants < 34 weeks' gestation who wanted to breastfeed were eligible to participate.
  
  
  METHODS
  Cup or bottle feeding occurred when the mother was unable to be present to breast feed. Infants randomised to the dummy groups received a dummy on entry into the trial.
  
  
  METHODS
  Full breast feeding (compared with partial and none) and any breast feeding (compared with none) on discharge home.
  
  
  RESULTS
  prevalence of breast feeding at three and six months after discharge and length of hospital stay.
  
  
  RESULTS
  303 infants (and 278 mothers) were included in the intention to treat analysis. There were no significant differences for any of the study outcomes according to use of a dummy. Infants randomised to cup feeds were more likely to be fully breast fed on discharge home (odds ratio 1.73, 95% confidence interval 1.04 to 2.88, P = 0.03), but had a longer length of stay (hazard ratio 0.71, 0.55 to 0.92, P = 0.01).
  
  
  CONCLUSIONS
  Dummies do not affect breast feeding in preterm infants. Cup feeding significantly increases the likelihood that the baby will be fully breast fed at discharge home, but has no effect on any breast feeding and increases the length of hospital stay.
authors.affiliation: Department of Nursing and Midwifery Research and Practice Development, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia, 5006, Australia. collinsct@mail.wch.sa.gov.au
authors.forename: Carmel T
authors.initials: CT
authors.lastname: Collins
authors.forename: Philip
authors.initials: P
authors.lastname: Ryan
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Crowther
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: McPhee
authors.forename: Susan
authors.initials: S
authors.lastname: Paterson
authors.forename: Janet E
authors.initials: JE
authors.lastname: Hiller
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015370:Infant Equipment / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D007234:Infant, Premature; D007902:Length of Stay; D041361:Pacifiers / Q000706:statistics & numerical data; D016312:Treatment Refusal