Background Tubefeeding with an electric pump is largely used in France. Manual tubefeeding by parents is used Swedish settings and was introduced in Toulouse in 2007.

Objectives To demonstrate the impact on infant’s behaviour during tubefeeding using manual administration by parents (map) versus administration by an electric pump (aep) over 30 min.

Methods This randomised trial compared map versus aep in a crossover design. Preterm infants born <33 weeks and >7 days of life were included. Videorecording was performed for each tubefeeding and observed blinded by two trained NIDCAP observers every 4 min during 60 min. Scoring system was used according to Dsilna A and al.

Results 15 preterm infants with a median GA 30.1 weeks (28.1–31.7) and BW 1210 g (1050–1520) were included. Map was performed over a median time of 27 min (22- 32), aep over 30 min. Installation, environment and infant’s state were similar between the two groups when tubefeeding was started. Signs of well-being were significantly more present during map in comparison to aep (36.2 (±8.0) vs 30.7 (±9.5), p = 0,04), especially “Hands to the mouth” and sucking patterns. There was no significant difference in signs of discomfort and stress (map 37.2 (±9.4) versus aep 41.9 (±13.2), p = 0,2) but motor retreat signs were significantly more present in aep.

Conclusion Our study demonstrated a difference in behavioural expression during tubefeeding among premature infants. Map was associated with signs of wellbeing and could be largely used in neonatal settings.