# Mechanism to Promote Safe and Efficient Oral Feeding in Preterm Infants

> **NIH NIH R44** · PREEMIE-PACER, LLC · 2021 · $1,062,573

## Abstract

PROJECT SUMMARY/ABSTRACT
There are 380,000 infants born preterm each year in the United States alone. Preterm infants often necessitate
care in the neonatal intensive care unit. One of the final milestones to be achieved in order to be discharged
from the neonatal intensive care unit is oral feeding. Oral feeding can be a challenge for infants born preterm
as they do not have the maturity that allows for coordinated sucking, swallowing, and breathing. Many infants
will suck and swallow, and their failure to breathe will result in dangerous physiological fluctuations. To help
with this, pacing techniques can be used. Cautious caregivers can intermittently pull the bottle nipple out of the
infant’s mouth to encourage breathing and recovery. This can be disruptive to the feeding process, can result
in significant energy expenditure, and can be stressful for parents. To address this problem, the Preemie-Pacer
bottle is in development. The Preemie-Pacer has an internal mechanism that interrupts the flow of milk to the
nipple intermittently to enable the infant to pause and breathe.
The long-term goal of this project is to develop an innovative bottle that will address the problems that preterm
infants experience during early oral feeding, allowing early feeds to occur safely and efficiently. The current
project aims are to 1) optimize the design of the Preemie-Pacer bottle with the addition of an ‘assessment
mode’ and internal memory unit, external display, and rechargeable base followed by doing laboratory testing,
and 2) improve usability by defining programming for individualized use of the Preemie-Pacer. To achieve this,
design work will be followed by laboratory testing of the device to ensure its durability, repeatability and
reliability. Then 100 preterm infants born ≤32 weeks gestation will be fed two times each week by a neonatal
therapist who will control the flow of milk using a sensor on the bottle, according to the infant’s behavioral
signs. Data will be downloaded and pooled and algorithms fit to the data to establish appropriate timing of flow
and run across different ages and other infant factors. These evidence-based rates will be incorporated into the
bottle programming and will play based on unique infant factors that the feeder enters on the Preemie-Pacer,
with the ability to adjust the rates if needed. This work will set the stage for clinical trials on safety and efficacy.
The Preemie-Pacer can have a significant impact on the care that preterm infants receive. If safe and efficient
oral feeding can be achieved even a few days earlier, significant health care dollars can be saved, and infants
can be discharged to their homes earlier. In addition, parents can potentially have more success and
confidence in feeding their high-risk preterm infants.

## Key facts

- **NIH application ID:** 10150446
- **Project number:** 2R44HD092210-02A1
- **Recipient organization:** PREEMIE-PACER, LLC
- **Principal Investigator:** Amit Mohan Mathur
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,062,573
- **Award type:** 2
- **Project period:** 2017-04-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10150446

## Citation

> US National Institutes of Health, RePORTER application 10150446, Mechanism to Promote Safe and Efficient Oral Feeding in Preterm Infants (2R44HD092210-02A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10150446. Licensed CC0.

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