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Feeding Neonates by Cup: A Systematic Review of the Literature

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Abstract

Objective WHO and UNICEF recommend cup feeding for neonates unable to breastfeed in low-resource settings. In developed countries, cup feeding in lieu of bottle feeding in the neonatal period is hypothesized to improve breastfeeding outcomes for those initially unable to breastfeed. Our aim was to synthesize the entire body of evidence on cup feeding. Methods We searched domestic and international databases for original research. Our search criteria required original data on cup feeding in neonates published in English between January 1990 and December 2014. Results We identified 28 original research papers. Ten were randomized clinical trials, 7 non-randomized intervention studies, and 11 observational studies; 11 were conducted in developing country. Outcomes evaluated included physiologic stability, safety, intake, duration, spillage, weight gain, any and exclusive breastfeeding, length of hospital stay, compliance, and acceptability. Cup feeding appears to be safe though intake may be less and spillage greater relative to bottle or tube feeding. Overall, slightly higher proportions of cup fed versus bottle fed infants report any breastfeeding; a greater proportion of cup fed infants reported exclusive breastfeeding at discharge and beyond. Cup feeding increases breastfeeding in subgroups (e.g. those who intend to breastfeed or women who had a Caesarean section). Compliance and acceptability is problematic in certain settings. Conclusions Further research on long-term breastfeeding outcomes and in low-resource settings would be helpful. Research data on high risk infants (e.g. those with cleft palates) would be informative. Innovative cup feeding approaches to minimize spillage, optimize compliance, and increase breastfeeding feeding are needed.

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Acknowledgments

Dr. McKinney and Ms. Rue were supported by NIH NCATS Grant #2KL2TR000421-06. This work was also supported by the Jean Renny Endowment for Craniofacial Research, Seattle Children’s Hospital Craniofacial Center.

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Authors and Affiliations

  1. Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, Seattle, WA, 98195, USA

    Christy M. McKinney & Matthew G. Vaughn

  2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

    Robin P. Glass

  3. PATH, Seattle, WA, USA

    Patricia Coffey

  4. Institute of Translation Health Sciences, University of Washington, Seattle, WA, USA

    Tessa Rue

  5. Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA

    Christy M. McKinney & Michael Cunningham

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  1. Christy M. McKinney
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Correspondence to Christy M. McKinney.

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McKinney, C.M., Glass, R.P., Coffey, P. et al. Feeding Neonates by Cup: A Systematic Review of the Literature. Matern Child Health J 20, 1620–1633 (2016). https://doi.org/10.1007/s10995-016-1961-9

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