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To receive enteral nutrition with the advantages of breast milk, hospitalized premature infants are fed pumped breast milk by gavage or, when nippling skills have developed, by bottle. Direct breast-feeding, however, often is considered too fatiguing for premature infants. Researchers in Israel used a metabolic monitor to measure resting energy expenditure for 20 minutes immediately after bottle-feeding and breast-feeding in 19 premature infants (gestational age, 32–34 weeks). Infants were aged 2 weeks or older, were growing well, were thermally stable, and could nipple at least 25 mL in one feeding. Infants on supplemental oxygen or with apnea of prematurity, infections, patent ductus arteriosus, or congenital anomalies were excluded. Each…