For years I have hated the red nipples ( and the blue ones) we used to use in NICU. Both of these are high flow nipples and pour out the feeding to the baby. I never understood the rationale for using them with preterm infants who historically have difficulty coordinating suck/swallow/breath. Yeah- you can get a ton of milk into a baby using these but if you observe them during a feeding, most of these poor babies demonstrate significant distress signals. Rapid flow nipples may often contribute to apnea or bradycardia during feedings since these babies have to swallow frequently to keep up with the volumn therefore decreasing the amount of time available for breathing. Thanks heavens we finally have trashed them out of our system here. If we have a baby that requires a higher flow than regular nipples we use a Haberman or a NUK. I prefer the Haberman since we can adjust the flow to the babys cues ( the NUK is just a standard High Flow) Another problem with these nipples (red and blue) is that they tend to promote poor oral motor strength and with their shortened length, promote inappropriate suckles due to inadequate contact between the tongue and nipple. In most cases using a "term" nipple instead also helps fill the oral cavity providing positional stability. I assume you baby is a term kiddo, recovering from being ill. If it's already spitting up large volumns of EBM, I doubt a high flow nipple would improve this. IMHO I would suggest using a different technique to feed this baby via bottle. I see more spit ups when we try and feed a breastbaby with a bottle in the old fashioned manner- you know- put nipple in, let baby suck down a half an ounce, burp, repeat. I have had better success permitting baby to only take 2-3 suckles on the bottle , then removing it ( pause) reinsert and remove again after 2-3 suckles. I have parents try and take at least 15- 20 minutes to feed 1-2 oz in the beginning and use the old reminder that its like their mother told them- chew your food 20 times before you take the next bite. For me , doing this, my mom's have less complaints of "pukey babies". and babies seem to transition better back to the breast. They didn't get the "plunger affect" during feedings away from mom I guess. Good luck- Lisa Jones RN CLE IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html