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. 2016 Oct 18;2016(10):CD005252. doi: 10.1002/14651858.CD005252.pub4

Mosley 2001.

Methods Randomised controlled trial, pilot study. Study duration ‐ 3 months
Participants Single centre, Special Care Baby Unit, District General Hospital, England
Inclusion criteria: gestational age 32 to 37 weeks, mother wishes to breast feed, no congenital abnormality, no maternal preference for cup or bottle, infant had not been fed by cup or bottle
Experimental group: mean gestational age 35.5 weeks, SD not reported; control group: 35.2 weeks, SD not reported
Sample size: 16 randomised (8 experimental/cup, 8 control/bottle); 14 included in analysis (6 experimental/cup, 8 control/bottle)
Interventions Experimental: supplementary feeds given by cup
Control: supplementary feeds given by bottle
Outcomes Prevalence exclusive breast feeding on discharge home
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "There were 10 instructions to cup feed and ten to bottle feed. These details were then put in the envelopes, shuffled thoroughly and then the envelopes were numbered sequentially".
Allocation concealment (selection bias) Low risk Quote: "Midwife/nurse responsible was asked to select a sealed, numbered, opaque envelope, which contained information on the feeding method to be adopted".
Blinding (performance bias and detection bias) 
 All outcomes High risk Not possible to blind intervention. No information provided on blinding of outcome assessors
Incomplete outcome data (attrition bias) 
 On discharge home Low risk Missing outcome data (n = 2, 13%) (experimental 2, control 0):
  • Protocol violation (Quote: "excluded from the study prior to its start....had been given a supplementary feed")


Comment: Although difference in proportion of incomplete outcome data was noted across groups (25% experimental, 0% control), the sample size was so small that we are unable to sensibly assess the impact of missing data. Low risk of bias due to incomplete outcome data
Selective reporting (reporting bias) Low risk Before clinical trial registration requirements, all expected outcomes reported
Other bias Low risk Nil noted