We encourage nurses to use the Haberman if they have decided that
baby MUST have a bottle.  (Yes, we're working on that attitude, but
want to compromise breastfeeding as little as possible while working
toward that "perfect world".)

Katie asks:
"Doesn't the Haberman bottle work with compression and not suction?
Why would you want to use this very expensive bottle ($20.00+ in our
area)
for a baby that can suck?"

To me that is actually one advantage!  While the pressure difference
between a "full" breast and baby's mouth is a factor in milk
transfer, it is baby's jaw action and tongur "wave" that are the
primary factors in milk transfer.  IMO, suction serves primarily to
keep the breast in place during breastfeeding.  One problem with the
usual bottle is that it dribbles in whether baby is doing anything
or not.  Baby does not have to keep the artificial nipple shaped in
the mouth and may use suction as a more primary factor in milk
removal.
The Haberman shape in baby's mouth is still like most artificial
nipples, which I feel is somewhat of a disadvantage, but it is still
more of a "milking" action that is needed to transfer milk from the
Haberman teat to baby's mouth.  I encourage the user to try to get
baby to take the Haberman nipple in over several sucks to somewhat
approximate the fact that it takes a few sucks for baby to draw the
breast to the back of the mouth and stimulate the same area that the
artrificial nipple hits immediately.

The other big advantage if the Haberman is that you can vary flow.
At breast, it may take several sucks to get the flow started.  I
have the user put the short line toward baby's nose for several suck
before rotating the entire device so that the medium line is toward
the nose.  One potential confusion factor I see in babies who have
gotten regular bottles is that they expect the "instant
gratification" they got from a bottle.  They may latch well, but
then appear confused or frustrated when they don't get a mouthful of
milk with the first suck.
With the usual style of bottle, "x" amount of sucking or jaw action
always giet "y" amount of milk until the bottle is empty.  At
breast, the flow may vary-faster at first as shown by swallowing
with each suck.  Then the flow can fluctuate with repeated MERs and
subsequent volume variances.  When using a Haberman, I encourage the
person to rotate the teat back toward the short line from time to
tome to imitate this variation.

She also said:

 "I have had some babies really start chomping at the breast
after using these bottles - trying too hard to compress Mom's
breast/nipples.
 Niples look compressed with white lines across the middle.  If she
is
supplementing by bottle, why not just a regular one with a wider
base?"

This shouldn't happen if baby is getting enough nipple/areolar
tissue in the mouth.  That may be related since baby doesn't have to
open as wide to take the Haberman teat, but I don't think it's the
jaw action that's the problem, it's the placement.  The wider base
artificial nipple does have the advantage of encouraging a wider
mouth opening like baby needs to do to latch effectively.  Hmmm-can
anyone come up with a set-up that  has the action and flow variation
of Haberman and the wide-mouth opening of the Avent nipple?  (I know
it already exists-the human breast.  I'm talking about those times
when for whatever reason, valid in our opinion or not, baby is going
to get a bottle.)

"It has become popular lately around here to have Moms using
Haberman's and I
feel that they are being way over used in most situations here."
That is always a danger with any "gadget".  They all have both
appropriate and inappropriate uses.  Nipple shields, for example,
can be useful in some situations, but we all know how they can be
over-used and mis-used.  In our case, we have to keep reminding the
staff that the recommendation to use Haberman IF baby is going to
get a bottle one way or another does not mean supplementing is "OK"
in any situation as long as you use the Haberman!

Winnie

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