I agree with this - mostly. But there are ways to measure bottle efficiency - which I'm not sure have been attempted yet. That is: use a strain gauge to measure the suction generated by the baby on the bottle and compare with what same baby generates with its own mother - mother serves as control. Do test weights to check volumes obtained (don't look at the bottle measures since it's already been shown that this is not accurate due to dribble factor). Ultrasound the baby on breast and on bottle and measure distance from lip flange to tip of nipple. Engineering-wise, holes of bottles expand with increased pressure, so even so-called slow flow bottles might be fast flow on an efficient baby. Donna Geddes et al work seems to show that too high pressures on the breast decrease flow rate because of excessive compression. No bottle will really offer the variability of flow that the breast is capable of through wax and wane of flow during and between MER's. This is rationale that I explain to moms for why there's not a one size fits all thing with bottles. With all that being said, I DO think there are ways to analyze and help moms determine what bottle might work for their particular situation rather than letting them flounder and buy 15 different bottles.
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of [log in to unmask]
Sent: Tuesday, June 30, 2009 7:34 AM
Subject: Code issues
No bottle and artificial nipple work like the breast. NABA has found numerous claims made by manufacturers of feeding bottles and nipples that state a particular bottle system works just like the breast or is the closest to breastfeeding. These are deceptive, false and misleading advertising. They are part of a marketing scheme to cause mothers to buy a particular brand of feeding system. There is no evidence to be able to state that one of these systems works more like the breast.
There is no reason to ever say to a mother that they work like the breast. Nipples are different shapes, may have differing flow rates, may be stiffer or more pliable and harder or easier to deflect, may be longer or shorter, may have differing types and numbers of holes, and may be made of differing materials, but none work like the breast.
Explaining which nipple might be more suitable for a baby whose mother is going back to work is problematic. Each baby usually winds up with his or her own preference for a particular nipple. Some babies could care less what is put in their mouth and will suck on anything. When I taught breastfeeding classes and talked about return to work I simply advised mothers to purchase a bottle system that was free of BPA, phthalates, latex, and any other contaminants and use a slow flow nipple for newborns that the baby would accept.
The Code does not preclude talking about products. It prohibits the marketing of products covered within its scope. Stating that a bottle feeding system works like the breast violates the Code, is not evidence-based, is false and misleading, is a claim used by industry to cause mothers to purchase a product, and has no place in our teachings.
Marsha Walker, RN, IBCLC
Weston, MA
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