Study population
congenital heart disease, congenital upper airway obstruction
EVENTS, RECRUITMENT, REFLUX
We recruited 68 preterm infants (birth gestation < 32 weeks) from an Australian tertiary neonatal unit. Eligible infants were: (i) self‐ventilating for at least 5 days prior to commencement; (ii) receiving full enteral feeds (>150 mL/kg/day) for at least 5 days and third‐hourly feeding for at least 48 h and (iii) not yet receiving formal nutritive oral/suck feeds. This group was selected to minimise confounding variables, such as changes to ventilatory parameters or enteral feed volumes during the study period. Infants receiving low‐flow sub‐nasal oxygen (<0.5 L/min) were eligible provided other respiratory criteria were met. Infants receiving caffeine citrate were included; however, dose was only adjusted for body weight during the trial period. Infants receiving nutritive oral feeds (counted towards daily fluid quota) were excluded as breast/bottle‐feeding precluded control of test conditions. All infants meeting criteria were considered for recruitment, irrespective of baseline respiratory events.Infants with significant comorbidities were excluded, including those that might preclude alternative positioning (surgical indications, symptomatic congenital heart disease) or confound interpretation of outcome measures (congenital upper airway obstruction, pharmacotherapy for gastro‐oesophageal reflux). Additional exclusion criteria included palliative care redirection or imminent discharge/transfer.