Hello, Diane.
I can't answer your questions about empty bottles and whether or not
baby gets more air, or if it matters. But you also asked, "By not covering the
holes with milk, do you find that the baby has to suck to drink, as opposed
to swallowing in self-defense?"
What I have seen over the years is, if the parents are *truly* using a
slow-flow nipple, the hungry baby will have to suck if he wants to fill up
his belly anytime soon. I always tell parents that when they buy a package of
nipples marked "slow-flow", they should test the nipples. Sometimes, the
nipples aren't slow, no matter what the packaging says. I tell them to put water in
the bottle and hold the bottle horizontally. Then tip the bottle to 8:00 or
4:00 (depending on whether they are left- or right-handed). The water should
drip out very slowly. If it drip, drip, drips very quickly, or just plain
streams out, it's not a slow-flow nipple. All brands make mistakes once in a
while, and some brands make more mistakes than others, so parents should always
check the nipples before first use. But if we use a true slow-flow nipple and
sit the baby upright, baby is not swallowing in self-defense. He has to work
for his dinner. And he doesn't get overfed, because he simply stops sucking,
like he would at breast, and the milk is *not* flowing from a slow-flow
nipple. Because the babies are not drowning, they can suck-swallow-breath like they
do at breast. Because they don't swallow a lot of air this way, I usually
see babies finishing 3/4 of the feeding or even the entire feeding before they
need to stop for a burp (winding), just like they finish the whole breast
before they (usually) need to be burped (winded).
The babies I have seen who get squirmy and need to stop and let out
loud burps when bottle-fed this way are the babies who are having sucking
problems that keep them from maintaining a good seal around the nipple, such as
dropping the lip away from the nipple when the jaw is lowered for a suck. These
babies get more air, and definitely get more uncomfortable, but it's because of
the air they suck in *around* the nipple, not air they are getting *through*
the nipple.
Hope this helps, and I'll be interested to see if anyone else has
experience to answer your question about the empty nipple.
Dee
Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA
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