The objective of the proposed research is to conduct a within-subject cross-over trial that will compare the efficacy of the two bottle-feeding positions on physiologic and behavioral responses of preterm infants prior to, during, and after feeding. As an exploratory aim, the investigators will also identify potential infant characteristics associated with the intervention response by evaluating infant sex, maturity level, and/or comorbidity. The two bottle-feeding positions will be the semi-elevated side-lying position (hereafter referred to as side-lying position) and the semi-elevated supine position (hereafter referred to as supine position), which is the traditional feeding position when preterm infants are bottle-fed. The investigators hypothesize that compared to the supine position, the side-lying position will be associated with greater physiologic stability in heart rate, respiratory rate, oxygen saturation, and/or autonomic nervous system regulation during and after feeding. The investigators also hypothesize that compared to the supine position, the side-lying position will be associated with more mature patterns of suck-breathe coordination and/or greater feeding skills.
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Infant physiologic responses to the feeding position - Heart rate (HR)
Timeframe: Up to 30 minutes post-feeding
Infant physiologic responses to the feeding position - Respiratory rate (RR)
Timeframe: Up to 30 minutes post-feeding
Infant physiologic responses to the feeding position - Oxygen saturation (SaO2)
Timeframe: Up to 30 minutes post-feeding
Infant physiologic responses to the feeding position - Heart rate variability (HRV)
Timeframe: Up to 30 minutes post-feeding
Infant physiologic responses to the feeding position - Splanchnic-cerebral oxygen ratio (SCOR)
Timeframe: Up to 30 minutes post-feeding
Infant behavioral responses to the feeding position - Suck-breathe coordination
Timeframe: 5-30 minutes post-baseline
Infant behavioral responses to the feeding position - Infant feeding skill
Timeframe: 5-30 minutes post-baseline