I don't want this to come across as at all antagonistic to you, Susan, as
you may have seen some newer study than Smith's that justifies saying that
his results are "out-dated." I'd just like to know what that statement is
based on. Certainly some types of research use methods that show a picture
of something and reveal information that may be clarified by better picture
taking at a later date.  The clarification does not necessarily invalidate
earlier research, but may amplify it.  For instance, we still rely a lot on
Ardren and Kemp's radiologic studies which were done back in the 50's!  What
Smith's ultrasound of nipples reveals seems quite sound to me.  Our
interpretations may change based on newer info and I guess that is what I'm
asking about and hoping you will share.  I think the issue is that there
probably isn't just one teat that is right for all instances.

 Teats (whether on a bottle, formed as a nipple shield, or on a pacifier)
are artificial representations of a breast (the real thing) which is what
normal infants feed from.  Infants with feeding problems who need
therapeutic intervention with artificial teats should be using said
artifices with the sole intention of selecting the one which will be most
helpful in moving them back to normal feeding, i.e. breastfeeding.  Or, to
use the method of alternative feeding least likely to distract the baby who
is separated by work situations, or whatever, from re-uniting with
breastfeeding at the end of the day.

 Given the fact that the reasons for poor feeding will vary, it makes sense
that selecting the teat should be on a case-by-case basis and be very
intentionally related to what the baby's problem is.  The Nuk teats have the
fastest flow rates (typically) and there may be reasons for selecting them
for feeding some infants.  I find it hard to think that the Nuk has the best
chance of patterning the tongue into a central groove or for creating
greater stability at the lips.  Also the shape of badly damaged nipples
assumes the NUK configuration, so if mother is having that problem, a shape
teat that encourages baby to hold that clamped jaw position seems unwise.


Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com

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