Hi Marla,
In my experience, it's not so much the nipple but how it is used.  If 
the nipple is crossed across baby's lips with the tip on the philtrum 
and the base against the chin, and baby must open wide to accept the 
bottle, this helps preserve breastfeeding behaviours.  Right now I like 
the Playtex natural latch and natural shape nipples, and the Gerber 
comfort latch nipple.  Unfortunately, both are non-standard, and don't 
fit on the bottles that fit on hospital grade breast pumps.  One hates 
to pour the milk around several times and lose fat on the sides of 
bottles, and take the chance of spilling it.

If you can still get some of the older style wide Evenflo comfi 
(formerly called Ultra) nipples, these were ideal.  Now in my area the 
comfi nipples are even skinnier than other standard nipples, and have 
been problematic.  When I was able to find the older wide ones, they 
were ideal because they fit on standard bottles, had a short teat and a 
wide base, so the baby could get the teat way back in their mouths by 
placing their lips well along the wide base.

The other important issue is flow control.  If the feeder holds the 
bottle more horizontally so that the nipple is only half full of milk, 
this will allow the baby better control of fluid flow, and make the baby 
work appropriately for the milk.

Dee Kassing has written an article on a similar technique for JHL, you 
can use that as a reference for the staff.
Catherine Watson Genna, IBCLC  NYC

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