Gromada's research on Haberman feeders found that they delivered about 7 ml/minute at 100 mmg of pressure, no matter what the "speed" setting.  The problem with this information is that the Haberman   DOES work by compression on any but the slowest setting, and ONLY by vacuum on the slowest setting. When you use vacuum only, and absolutely no compression, as you would on a testing machine, you get the same speed no matter what line goes where.  Babies who are efficient feeders use vacuum mostly and a tiny bit of compression and adjust their vacuum levels according to flow of milk (according to Donna Geddes research).  The problem with the feeders is that most people do not really pay attention to what is happening with the line.  Babies can turn the nipple while sucking if you are not paying attention.  Also, I have found that the position baby is held is VERY important in trying to help a baby develop better sucking skills - side-lying with the body in a flexed position (elbows on the dinner table, walk-like-an-Egyptian (referring to the song that was popular in America a few years back) chin position with jaw  forward and supported.  You can't feed from a bottle prone, not even a Haberman! 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Susan Burger
Sent: Tuesday, June 21, 2011 7:31 AM
Subject: Re: What mother's hear & Haberman bottles

Dear all:

It is always a challenge to put yourself in the place of the mother who may hear the information we think we are articulating quite differently than we intend.  So, I myself will sometimes use the Haberman bottle with mothers who don't want to use a tube on the breast but really don't want to use a bottle when the baby really cannot finish a feed from the breast.  They can accept the Haberman a little more readily.  While I explain that the bottle works on compression, they may not always "get" how the bottle works. I can definitely see how a mother might not hear my distinctions between flow preference and nipple confusion because nipple confusion is such a pervasive fear among mothers.  I do feel that I see fewer babies having problems adjusting to the flow from the Haberman than I do from free flow bottles.  

I also have to deal with baby nurses and relatives that insist on pouring milk down a baby's throat.  I have seen babies doing quite well until the baby nurse took over and undermined all the careful bottle feeding techniques taught to the mothers.  So, I sometimes use Haberman bottles in self-defense because you CAN'T pour milk down a baby's throat with a Haberman bottle.  Sometimes tool use is not always directly for the baby's benefit but more of a fending off those who would feed the baby badly using standard bottles. Sometimes clients come up with their own explanations for why tools work or don't work.  I'm not sure that you might not have a few of my clients that walk away thinking the bottles were for nipple confusion despite my explanations. I don't get hard core about forcing mother's to understand tools in my terms -- I feel they need to understand tools in their own terms and if the tool is working great.  If the tool isn't working, then its time to reexamine what is going on.  

I still have a few mothers who really had marginal breast tissue who are convinced that it was the soup that they concocted that made their milk supply improve when I firmly believe it was the frequent drainage of the breast.  In the end, does it really matter if the mother is doing both things and increases her milk supply?

I know that there are some speech language pathologists that insist that the Haberman is faster than some other bottles, but I truly have not seen this when mothers carefully pace the baby by turning the bottle to a flow that seems to work well for the baby.  I have seen mothers use this bottle very well for pacing purposes.

I don't use Haberman bottles often.  When I do, I'd say 90% of the time they end up helping the baby that has plateaued in their ability to remove milk directly from the breast to finally improve enough to be able to shift to finishing feedings directly on the breast..

I have also seen some babies who do NOT eat well on the Haberman.  These babies typically feed poorly on any alternative feeding device.  These are the baby's that seem to want a fast enough flow so that they get a big bolus of milk and then squirt milk out of the corners of the mouth.  Anytime you change them from one device to another, they will initially feed well, then they will adapt and find a way to get that big bolus and squirt milk out of the corners of their mouths.  They will do this with regular bottles, Haberman bottles, tubes on the breast, tubes on fingers or thumbs, and they are really terrible at feeding from cups.  They feed the same on the breast.  I think I've seen about six or seven of these babies out of about 5,000+ babies.  I have NOT seen a direct relationship with posterior tongue tie -- yet.  

Best regards,
Susan E. Burger, MHS, PhD, IBCLC

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