# Right and Left Side-Lying Positioning During Bottle-Feeding in Premature Infants—A Randomized Crossover Pilot Study

## TL;DR

This pilot study found that feeding premature infants on their left side may improve oxygen levels and feeding efficiency compared to the right side.

## Contribution

The study is the first to compare left and right side-lying positions during bottle-feeding in premature infants using physiological and qualitative measures.

## Key findings

- Left side-lying position showed higher oxygen saturation and lower heart rate after feeding.
- Infants consumed more milk and had shorter feeding times in the left side-lying position.
- SpO2 declines were shorter in the left side-lying position compared to the right.

## Abstract

Background/Objectives: Optimal feeding position may contribute to improving the quality and safety of bottle-feeding in premature infants. The aim of this study was to compare the advantages of right side-lying (R-SLP) and left side-lying (L-SLP) positioning during the bottle-feeding of preterm infants. Methods: The randomized study included eight neonates (n = 8) born at ≤34 weeks of gestational age (GA). Four bottle-feeding sessions were conducted for each newborn: two in the R-SLP and two in the L-SLP position. Levels of oxygen saturation (SpO2) and heart rate (HR) were measured as indicators of physiological stability. The qualitative aspects of feeding included total time of SpO2 declines to ≤85%, the newborn’s alertness level based on the Neonatal Behavioral Assessment Scale (NBAS), and the number of possetings, regurgitations, and choking episodes. The volume of milk consumed and the duration of each feeding session were also recorded. Results: The L-SLP position was characterized with higher SpO2 (p = 0.042) at the 10th minute after feeding and lower HR (p = 0.022) at the end of feeding. Greater milk intake (p = 0.042), shorter feeding duration (p = 0.021), and shorter duration of SpO2 declines to ≤85% (p = 0.025) were also observed in L-SLP. No differences were found in alertness level, or in the number of choking episodes, possetings, or regurgitations compared to R-SLP. Conclusions: This pilot study suggests the potential efficacy of the L-SLP position during bottle-feeding of premature infants. The results require the need for larger studies to confirm the potential benefits of using L-SLP.