Hi, Jamelle.

If you're referring to the study referenced in the table found in Breastfeeding & Human Lac "Comparison b/w Breastfeeding and Bottle-feeding in Full-term Infants," it is Matthew OP. Regulation of breathing patterns during feeding.  In: Matthew OP, Sant Ambrogio G, eds. Respiratory function of the upper airway. New York: Marcel Dekker, 1988:535-60.

However, I think respiration differences aren't thoroughly understood yet.  For example, one study showed a difference between the type of fluid *in* the bottle, specifically that "better coordination between swallows and breaths could be obtained and subclinical aspiration could be prevented" with breastmilk in the bottle.  Mizuno K et al. Effects of different fluids on the relationship between swallowing and breathing during nutritive sucking in neonates.  Biol Neonate 2002;81:45-50.  

Further, we know that the volume of the flow has a tremendous effect on how a baby coordinates swallowing and breathing.  In Goldfield et al's study which was funded by Playtex, they found that respiration rates were better with infants who used the playtex bottle over infants who used the avent bottle.  What they failed to mention, and what is not recognized in our literature regarding this study, is that the avent system flows more than *twice as fast* as the playtex system.  I am not surprised that babies will coordinate swallowing and breathing on a slower flow.  Goldfield et al.  "Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding."  Pediatr Res. 2006; 60(4):450-5. 

We expect breastfeeding to provide better oxygenation and respiration because breastfeeding is biologically normal.  But if bottles are needed, we need to consider what is in the bottle, if the shape of nipple chosen supports optimal mouth positioning, if the flow chosen is similar to mom's personal flow, and use gravity and pacing to the baby's advantage.  Also, we need to be careful not to broadly apply studies (mentioned in previous posts) from preterm babies to full term babies.  We can extrapolate a bit, but the data would likely be different if the studies were repeated on full term babies.  

Hope these ideas help.

Amy Peterson, IBCLC

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