I think that this speaks to our desire to put science into something that
just does not lend itself to that end. Breastfeeding and bottlefeeding are
just completely different processes in almost every way, except that the end
result in both is putting something into the baby's stomach. It is like
trying to compare a natural vaginal birth to a csection - they are just two
different processes that result in the birth of a baby. If all you are
interested in is the end result, then what happens in between doesn't much
matter. In the case of a physical problem or threat to the life of mother or
baby, then it absolutely doesn't matter - feed the baby, deliver a live baby
with a living mother. It's all those other cases where it gets fuzzy. I
absolutely believe that we can do things to help moms who must use a bottle
to feed their babies, to make it easier for both mom and baby, to help them
preserve breastfeeding to whatever degree desired or possible. But there is
no magic bullet. Breasts are breasts. Teats are teats. One is made of living
tissue attached to a human being, the other is an inanimate object attached
to a bottle. We need to focus less on trying to find the magic teat and more
on all the other stuff we can do consistently to help mothers, regardless of
what kinds of bottles or teats they have access to.

Sharon Knorr, BSMT(ASCP), IBCLC


On Tue, Feb 15, 2011 at 12:24 AM, Karen Gromada <[log in to unmask]> wrote:

> Diana notes the most important reason for avoiding brand names - companies
> are constantly changing or "improving"(!) them. A company may change
> vendors, the size, the shape, the hole size or placement -- accidentally or
> on purpose. (In general, I think it's on purpose to reinforce a need for
> the
> product and/or to save production costs.)
>
> There are no standards in the USA and I'm unaware of any in other countries
> for what a company puts on a label/package for feeding bottles and/or
> related nipples/teats. What does "slow flow" mean - NOTHING. (It may mean
> slower than the company's next level of nipple/teat, but even that isn't
> necessarily so.) What does it mean to insert the word "breast" as part of
> the product's name or claim it's "most like breast" or something similar -
> NOTHING.
>
> If we all lined up (perhaps at an ILCA Conference) and lifted our shirts,
> there would be no one "like breast" -- we come with all kinds of workable
> breast/areola/nipple sizes, shapes, protractility, etc. (So whose breast
> did
> all those whacky companies use to model their feeding-bottle nipples/teats
> on?!?) And it's absolutely impossible to recreate the very active oral
> behaviors a baby must coordinate to draw in the breast, form the teat,
> create a seal, then use the tongue in several different ways, etc. via the
> fairly passive oral activities associated with feeding from a bottle with
> nipple/teat. (It's interesting that bottle-feeding is associated with
> sucking when most feeding-bottle nipples/teats are so fast that babies must
> (and can) use compression if they are to obtain liquid but still have
> enough
> control of the bolus. Yet it wasn't that long ago when we thought
> compression played more of a role in removal of milk at breast...)
>
> There are no standards so any company can claim their nipple/teat can do or
> be anything. They can change something, give it some slightly different
> name
> and proclaim it as "new and improved." Or they can quietly change
> something,
> e.g. the manufacturer, material, etc. and say nothing about the change.
>
> No nipple/teat-testing data is worth much within 1-2 years of the test. A
> colleague and I tested lots of bottle nipples in the last few years via a
> breast pump -- happy to share process but it's impossible to keep up with
> them. Recently, we've had some negative parent feedback on one we'd found
> to
> be more compatible with wave-like sucking -- babies having behaviors
> associated with faster flow, which leads to (mal)adaptive feeding behaviors
> to accommodate breathing. Things change and the feedback is leading me to
> believe a quiet change has taken place for another nipple/teat...
>
> Fortunately, we don't really need the data. It's possible -- and better --
> to read the baby vs any nipple/teat data. Babies "tell" us when they're
> having difficulty with shape, length of teat, material of teat, etc,
> although there's no real data on those aspects of bottle-feeding. And they
> tell us when a teat is too fast flow, forcing them into airway protective
> (and contradictory to breastfeeding) oral behaviors. (There is LOTS of data
> on effect of flow rate.) Baby chokes, gags, coughs, sputters, etc --
> obviously too fast. Baby clenches/bites on nipple/teat (to halt flow to
> give
> self an opportunity to breathe) or drools a lot (lowering oral tone to
> "lose" some of the bolus in order to handle bolus with breathing) or
> demonstrates aversive behaviors (turns or tries to turn head to side or
> bats
> at feeding bottle with hand/arm in uncoordinated slow mo) -- saying "too
> fast" in more subtle ways.
>
> Sorry to ramble but it frustrates me when parents believe something simply
> because some slick marketing campaign aligns their nipple/teat product with
> the breast. And it frustrates me that there are so few appropriately
> slow-flow feeding-bottle nipples/teats to use when a newborn or young baby
> needs supplementation and stressed parents reach for the culturally
> familiar. Not to mention it frustrates me to hear about nursing strikes in
> the over 3 month old who has been "graduating" to ever-faster bottle
> nipples
> and then mothers wonder why they strike.
>
> Bottom line - (all this and you could've just jumped to the end) -- Read
> the
> baby -- not the product label or the data -- and teach parents how to do
> so.
> (And once the appropriate slow-flow nipple/teat is found, never let it go.
> Forget "graduations" to faster flow.)
>
> It's late - hope this makes sense!
>
>
>
>
>
> > Date:    Mon, 14 Feb 2011 13:14:11 -0500
> > From:    "Diana West, IBCLC" <[log in to unmask]>
> > Subject: Re: Medela Calma teat
> >
> > >maybe the BFAR/Lowmilksupply.org people are doing some more bottle
> > >research???  (nudge nudge...)
> >
> > We haven't ever done any -- Lisa and I just posted our opinions (now
> > dated and badly in need of updating) of optimal nipples for
> > supplementation on the lowmilksupply.org site.  My to-do list is very
> > long, but updating this is on the list, so if anyone has any opinions
> > or new research to point me to, please feel free to send them.  Do
> > note, though, that I'm going to try to avoid brand names at
> > all.  They change too frequently and are not available globally.
> >
> > Diana
> >
> >
> >             ***********************************************
> >
> >
>
> --
> Karen Gromada
> www.karengromada.com/
>
>             ***********************************************
>
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