I've mentioned this before -- a CCC-SLP, IBCLC colleague and myself have used a systematic method for testing flow rate of bottle teats, including all the ones various posters have asked about today. We shared our info, including some retesting and new addtions, at both poster and session presentations. If interested in our results, please send a personal email with reason for request/how you might use the info. (I'll explain why we ask for this when I forward the abstract.)

There appears to be NO research evidence to favor one type of alternative feeding method over another re: better for transitioning babies to direct BF. (I don't include thin nipple shields as an alternative feeding method. To me that is BF if milk transfer is occurring.) If anyone has such research, I'd sure love to see it -- really -- been searching a while! ALL alternatives have risks as well as possible benefits. As per others I've found most mothers find other options to be tedious or "strange" and most go to the bottle within days to weeks -- may be part of cultural familiarity in conjunction with the stress of infant feeding difficulty. I've also had mothers who said they were interested in other alternatives but it turned out they were telling me what I wanted to hear back then -- and several gave up on BF altogether.

Bottle-feeding and BF do not have to be mutually exclusive. Teat flow rate is a factor as is feeding technique. I don't think bottle-feeding is a good way to assess for BF suck, although again, teat flow rate and feeding technique can influence it. Bottle-feeding via true slow-flow teat takes different behavior than via a fast-flow one. 

Stepping off soapbox. Again, if anyone is interested in our abstract, please let me know. Never imagined myself in the business of teaching colleagues or mothers about "how to bottle-feed," but the more I learn, the more I think it's necessary and unethical not to share better ways to bottle-feed due to neonata airway safety issues (and related infant stress cues) with several teats used in-hospital in the immediate postpartum and at home teats. The lack of info on this topic is appalling. The lack of "training" for staff is appalling, but difficult to teach when so little info is available. That it has received so little interest as a topic for research is appalling. (There is some info re: preterm infants but little to nothing for full-term neonates.) And we wonder why the attitude re: "able to feed a stone" developed!

OK, now I'm really getting off the soapbox!

Karen

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