<since this is similar to the shape of a nipple when flattened on the roof of the mouth by the baby's tongue.> This seems like circular reasoning to me. As I understand it, though there was originally claimed to be research undergirding the development of the orthodontic nipple, it was later found out that there was no such research. It seems they simply patterned it after the "look" of nipples after babies came off. For years, in my teaching, I used the phrase "Nuk-look" to warn mothers that if their nipples looked like that, the baby did not have a deep enough "grasp". I also referred to it as the nipple having a "peak" like a ball cap. I later began hearing other people refer to this form of nipple trauma as "the shape of a new lipstick", and I have adopted that term. But for that very reason, according to my read of the recent JHL Kossing article, a nipple with a rounded end is her recommendation. (Also a broad base, although the one pictured in the article does not seem as broad as others on the market.) Way back when advising the Nuk was in vogue (I swallowed their advertising hook line and sinker because it looked so authentic and logical!), I did like the idea that the opening does release the milk against the top of the palate area. (Many parents inserted it upside down, in which case the milk is delivered into the surface of the tongue. But might that have some slight value in the case of cleft-palate babies?) I suppose I recommended it because my experience was (and still is) that a central hole often squirts a jet of milk straight back into the gag reflex/nasopharyngeal area. This results in "chuggalugging", the apparent "look how hungry the baby is" misinterpretation that is really evidence of a stressful attempt to breathe without choking while trying to coordinate sucking, swallowing and breathing. Kossing's point of holding the baby at a near 90 degree upright angle and to be careful of the angle at which the bottle is held to reduce the effect of gravity, along with the use of a "slow-flow" nipple, seems to help avoid that. I have even wondered what would happen if "blind" nipples (teats) were bought, and holes place slightly down the side of the nipple to release milk a little further forward rather than squirting at the throat. It might at least avoid the shallow placement of the smaller part of the nipple too far forward in the baby's mouth, as happens when many people feed a bottle. I think her article is very thought provoking and especially useful as ammunition in retraining grandmas and baby sitters who are certain they know all about how to feed a bottle! Jean *********** K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA *********************************************** 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