Supplementation with cup-feeding as a substitute for bottle-feeding to promote breastfeeding

Background: Few studies have provided evidence to verify that bottle-feeding has negative effects on breastfeeding. There is insufficient evidence to support the practice of cup-feeding to supplement breastfeeding. However, it has been applied as a substitute for bottle-feeding to promote breastfeeding. The aims of this study were to explore the differences in infant sucking competence, infant sucking behavior and maternal milk supply among babies who were exclusively breastfeeding (breast group), breast feeding with cup supplementation (cup group) and breast-feeding with bottle supplementation (bottle group) at different periods postpartum. Methods: A longitudinal study was carried out at a medical center located in northern Taiwan. The cup and bottle groups were recruited at two different times to avoid interaction. The breast group consisted of infants who were fully breastfed and were never exposed to a bottle or a cup during the hospital stay. Two hundred and five healthy mothers and their full-term, singleton infants were eligible for enrollment. We used structured questionnaires and made observations to obtain information on breastfeeding at the first breastfeeding and the third day after birth, and then followed up these cases at two and four weeks. Results: The bottle group was significantly more fretful during breastfeeding (p < .01). Mothers in the bottle group perceived that their milk supply was less sufficient than those in breast and cup groups (p < .01). Conclusions: Some indicators of breastfeeding were similar in the breast and cup groups. Cup-feeding was better than bottle-feeding when supplementary formula was needed for medical treatment.