Hi Susan,
Thanks for the clarification.  I have not heard that the Smith article is
used to promote the playtex.  It would be a stretch, because no specific
teats are mentioned in the Smith article.  It merely describes use of
ultrasound to visualize the inside of the oral chamber of the baby during
breastfeeding.  It reveals elongation of the human nipple during
breastfeeding (to approx 2 times resting length), and the compression of the
nipple in the transverse plane as the nipple is pressed between the tongue
and palate.  The diagram of this representation shows a rounded, thinned (by
about half resting diameter) nipple at maximal compression.

 In fact, the neat thing about the Smith article is that it's intention is
to provide a an "...in vivo imaging technique [that] has greast potential
value in the study of feeding dysfunction."  And it presumes that "The
ability to adequately sustain oral nutrition is vital to the survival of
infants.  In human newborns this means the ability to nurse effectively, an
act entailing a complex interaction between the milk source and the infant's
mouth and oropharyx.  The human nipple is a unique organ that facilitates
this complex process of suckling."  So I read it as using breastfeeding as
the norm and the activity of the human nipple during breastfeeding as the
reference point.  The picture diagram and the ultrasound view don't look
like either a nuk or a playtex to me.

There is another article by Mathew,O. Determinants of Milk Flow Through
Nipple Units, AJDC 1990, 144:222-224, which does discuss commercial teats by
name.  It's conclusion is that the "...differences in hole size primarily
accounts for the observed variability in milk flow [between teats].  This
finding may be clinically important in that rapid milk flow can lead to
apnea and bradycardia in some preterm infants."  Further on the article
states:  "In general, NUK type nipples had larger feed holes compared with
standard nipple units for term infants...Greater hole size was associated
with higher airflow and milk flow."  So based on this data, a nuk type
nipple might be a really bad choice for an infant with compromised
respiratory status or for an infant with a swallowing disorder.  Maybe a
big, hungry, normal term infant with a sort of weak suck might like a nuk.
I have heard Chele turns them upside down.  I wish I could remember the
rationale for that, as I'm sure she has a good reason for doing so.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com
----- Original Message -----
From: <[log in to unmask]>
To: Lactation Information and Discussion <[log in to unmask]>
Cc: <[log in to unmask]>
Sent: Thursday, April 27, 2000 02:32 PM
Subject: Re: NUK and Smith's studies


> I wish I could address all of the questions you raise, Barbara. I am sure
there
> is someone who could. I guess, I am just not so friendly to these
Ultrasound
> studies because they are used by many to justify use of the Playtex Nurser
as a
> "preferred feeding method" for breastfeeders. My experience, and that of
many
> others is, that this particular nipple causes shallow sucking and makes it
quite
> difficult to move a baby back to breast.
>
> Nuk is not my favorite nipple either, though I've found it helpful in
babies
> with a tight, biting latch. Chele Marmet seems fond of using it upside
down.
>
> A central groove in the tongue is not the only component of effective
> breastfeeding....and I think Smith would agree here. The problem is that
the
> Smith's research is being used by OT/PT people to convince us that it is.
>
> I am sorry if I came off as judgemental and overbearing. Perhaps I
shouldn't
> have said the information was outdated as much as overused and not
supported
> anecdotally.
>
> Sometimes just because something is logical doesn't mean it works.
>
> Susan Keith-Hergert RN, MS, CPN, IBCLC
> Mercy Health Partners
> Cincinnati
>
>
>

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