Evidence map›Paper›PMID 31622421›Full record

Trial reportPloS one2019

A randomized crossover trial comparing the Nifty cup to a medicine cup in preterm infants who have difficulty breastfeeding at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana.

Christy M McKinney, Gyikua Plange-Rhule, Daniel Ansong, Michael L Cunningham, Irene Agyeman, Patricia S Coffey

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Systematic Review of Growth in Young Children With Cleft Lip and/or Cleft Palate From 0 to 24 Months of Age.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026
    Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Christy M McKinneyDivision of Craniofacial Medicine, Department of Pediatrics, School of Medicine, University of Washington, Seattle Children's Research Institute, and Seattle Children's Hospital Craniofacial Center, Seattle, Washington, United States of America.
Gyikua Plange-RhuleKomfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, School of Medicine and Dentistry, Kumasi, Ghana.
Daniel AnsongKomfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, School of Medicine and Dentistry, Kumasi, Ghana.
Michael L CunninghamDivision of Craniofacial Medicine, Department of Pediatrics, School of Medicine, University of Washington, Seattle Children's Research Institute, and Seattle Children's Hospital Craniofacial Center, Seattle, Washington, United States of America.ORCID 0000-0003-2277-654X
Irene AgyemanKomfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, School of Medicine and Dentistry, Kumasi, Ghana.
Patricia S CoffeyDevices/Tools Global Program, PATH, Seattle, Washington, United States of America.ORCID 0000-0001-8961-0910
Komfo Anokye Teaching Hospital · GHSeattle Children's Hospital · USProgram for Appropriate Technology in Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPreterm infants make up the majority of the 9 million babies born in Africa and South Asia requiring supplemental feedings as they transition to exclusive breastfeeding. The World Health Organization recommends the use of a cup to feed newborns with breastfeeding difficulties in low-resource settings. We set out to evaluate the Nifty cup, a new feeding cup designed specifically for infants with breastfeeding difficulties. MATERIALS AND

methodsWe conducted a randomized clinical trial in Ghana. We hypothesized infants would prefer the Nifty cup and that it would have less spillage as compared to a medicine cup. We enrolled mothers and preterm infants with breastfeeding difficulties indicated to cup feed at Komfo Anokye Teaching Hospital. Each mother-infant pair used the Nifty cup and a standard medicine cup; and two feeding assessments with each cup were conducted. We employed an intent-to-treat analysis comparing cup preference using a Wilcoxon signed rank test and spillage using generalized estimating equations.

resultsWe enrolled 200 mothers and 237 infants. Many infants were very low birth weight (62%), less than two weeks old (62%), and multiple birth (29%). In response to separate questions about each cup, more mothers reported liking the Nifty cup a lot as compared to the medicine cup (85% versus 57%, p<0.001). When asked to choose between the two cups, more than 75% preferred the Nifty cup (p < 0.001). There was slightly less spillage with the Nifty cup (8.9%) versus the medicine cup (9.3%), which was not statistically significant (p = 0.35). Mothers reported greater confidence and ease of using the Nifty cup and greater use one-month post-discharge compared to the medicine cup (p-values <0.001). Nearly all mothers were breastfeeding and cup feeding their infants at study initiation and at one-month post-discharge. DISCUSSION: This is the first randomized clinical trial of cup feeding in sub-Saharan Africa. Mothers prefer the Nifty cup to a medicine cup for supplemental feeds to their preterm infant. The Nifty cup was used with greater ease and confidence. The Nifty cup can offer an improved feeding experience for the mother-infant pair.

Indexed as

Bottle FeedingBreast FeedingCross-Over StudiesEquipment DesignFemaleGhanaHospitals, TeachingHumansInfant, NewbornInfant, PrematureInfant, Very Low Birth WeightIntention to Treat AnalysisMale

Identifiers

PMID31622421
PMCPMC6797128
OpenAlexW2981055117

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.