I was interested in Barbara's comment about using an "increasingly wider
based bottle teat" (ie "from narrow teat to Avent to help baby learn to
flange the lips").

I would like to discuss this point in view of Michael Woolridge's (1986)
ultrasound research  showing how when the baby is milking the breast
effectively the nipple reaches back to the hard and soft palate junction and
the mouth is filled with breast tissue which in turn facilitates a
coordinated wave like motion of the tongue to  effectively milk the sinuses
behind the nipple 9see also the key to successful breastfeeding by Rebecca
Glover for  a visual understanding of what the tongue does (is supposed to
do) and the many videos around explaining correct attachment).

The  teat mentioned by Barbara is not sufficiently long enough or large and
flexible enough to reach to the soft and hard palate junction or mould
within the baby's mouth.

Is there is evidence to show that if the lips are flanged, the baby will
improve what goes on inside the mouth. Or if the lips are flanged does it
mean the baby is getting good milk transfer. Or maybe if the lips are
flanged something important happens inside the mouth to correct the suckling
for good milk transfer or to help the baby learn to suck effectively.

in view of research mentioned above and in view of ILCA guidelines from
"evidence based guidelines for breastfeeding management during the 1st 14
days" page 6, I wonder how much emphasis can be placed on "flanged lips"  to
ensure what is going on inside the baby's mouth for effective milking of the
milk sinuses of the areola.

I find it difficult to understand why  manufactures do not  manufacture a
teat that does the job to resemble the mechanical physiology of what goes on
at the breast. They at least try for every other animal under the sun.

The teat for humans would need to be long enough to reach the soft/hard
palate junction and soft and malleable enough to fill the mouth when baby
sucked, encouraging the tongue to stay down and be able to ripple in wave
like coordinate motion to milk the sinuses under the areola. Ideally the
teat would even be stretchable so that the baby could grasp to pull in the
main bulk of the teat into the mouth as they do at the breast. One would
think in this day and age of technology someone would  take this seriously
to help those women and babies who have difficulties.

I am interested in comments regards clear signs evident to observer and to
mother regards being able to confirm milk transfer. I have understood from
the research evidence that audible swallowing would be more important than
flanged lips which is only one sign of good attachment not evidence that all
else for good milk transfer is happening and confirmable.

Ruth

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