The problem with Avents and Similac bottles is that they work by compression.  If you have a baby who needs to learn to suck, a compression bottle doesn't help, IMHO. My personal beef is with wide bottles period which require the baby to almost look to the ceiling to get the last 1/2 oz from the bottle.  Fine if it's formula.  Don't want to waste breastmilk.  I like the narrow skinny bottles (which means I DON'T like Medela's new design bottles) because of the flexibility of positioning babies on their sides or in a sitting position without pressure being placed behind the shoulders (which encourages arching behaviors).  Let me say that I work with about 20-30 outpatients a week and have been doing this since 1987 so my view is prejudiced by experimenting with every single bottle ever made since 1971 and every pump made since the same date when I started my personal breastfeeding career.  I am a research junkie and really appreciate good measuring tools that have been used and developed by the Australian and beyond teams around the world.  The fact that Medela has chosen to invest their private profits into research has been a bonus to every breastfeeding field, IMHO and they get high marks for that.  The marketing department, however, does not "get" breastfeeding advocates.  HOWEVER - latest research I read is the lack of good support information and lots of conflicting advice on internet and provider-based.  How we fix this is to concentrate not on just the promotion of breastfeeding but providing excellent evidence-based research on solving the dismissed issues affecting breastfeeding.  And I say dismissed, because the solution is: give them formula, get a bottle. 



-----Original Message-----

From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Amy Peterson, BS, IBCLC

Sent: Thursday, November 29, 2012 8:23 PM

Subject: Re: Medela calma nipple



I agree with you, Jane, that bottle nipples need to be used as tools and with guidance, particularly in your excellent example of babies who need help with central tongue grooving.  I concur with that use...except the babies I work with, once things improve, are so overwhelmed with the flow of the Calma.  Other firm, long, nipple shapes (such as avent, browns wide, etc) also work well for tongue grooving and they have a slower flow.  I am thankful that there are many choices available on the market to help the babies we work with.  



The main point I was making, as the "somebody" who mentioned flow rates  :)  is that compared with other nipples in a controlled situation with the same amount of suction applied, it IS faster. (recognizing vacuum as one variable that is measurable)  Hence, since it is marketed to the general public, not to be used as a tool with guidance but to replace breastfeedings for as many mothers who will buy it, moms need to understand flow. 



I would be interested to hear experiences of how the Calma worked for babies without suck issues; the only ones I know of (moms returning to work, babies nursing fine) couldn't tolerate the flow.    



Amy



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