Thank you so much for sharing this article, Nikki.

Many families who are bottle-feeding and/or giving pacifiers to their infants report preferences by their babies for a particular style of artificial nipple, and this is also frequently observed in regard to specific styles of sippee-cups, particularly but not only during early learning.  Many adults acknowledge a preference for drinking from a certain style of water bottle, etc.  

A stable repertoire is often limited.  In infants who have learned how to breastfeed as well as bottle-feed, a particular style of artificial nipple is often reported to be preferred by the infant, while one or more other styles are refused by the baby, and/or babies struggle in their attempts to orally grasp the novel artificial teat.  Families and caregivers typically do not make an effort to give babies alternating styles of artificial nipples on an ongoing basis, but tend to choose one style for which the baby displays greatest motor control for the oral grasp and effective transfer.  

It may be intuitive for many families and caregivers to provide one style of artificial nipple to an infant, rather than expecting the baby to competently switch back and forth between various styles on a regular basis.  For many other families, it's a learning opportunity to observe a baby's struggle with a novel style of artificial nipple.  Even among elite performers, switching back and forth between equipment styles is not effective, task-specific practice.  For example, it would be unthinkable for the professional tennis player to switch back and forth between different styles of tennis rackets on an ongoing basis.  The professional musician will not rehearse for a job audition on a clarinet when one's instrument is the oboe, and so on.  

In NICU and pediatric units, it's routine for the departing nurse to give the incoming nurse a report on her patient's status, and this often includes what type of artificial nipple a baby is using re: "doing well" with Brand A or Brand B, etc.  This report is understood by the incoming nurse that the particular style of artificial nipple should be continued rather than discontinued, since the baby is learning the oral grasp and effective sucking, as well as how to coordinate suck and swallow with breathing.  In order to continue to build skill in these areas, the repetition of task-specific practice is necessary and imperative.     

An important area to study is measuring infants' reaction times, movement times, and response times to various styles of artificial nipples as they undergo task-switching, with the subsequent displays of associated switch costs of decreased speed and accuracy in performance.  Real-time studies utilizing these measurement parameters are long overdue in human infants in regard to unfettered skill acquisition at the breast, as well as task-switching studies between breast and bottle as well as breast and pacifier.  There are also ethical concerns that must be considered in designing such studies.   

Discussion topic:  To all Lactnetters who are currently bottle-feeding and/or giving pacifiers/soothers to your babies, or who have bottle-fed and/or given pacifiers to your infant in the past, whether or not your baby also learned to breastfeed, did your baby ever display a preference for one style of artificial nipple?  When given a novel style of artificial nipple, did your baby ever struggle with the new style of artificial nipple, as if finding this new learning experience to be confusing? 

According to the child development literature, the younger we are, the least cognitive flexibility we possess for competent task-switching.  Developmental cognitive neuroscientist Adele Diamond refers to this as "attentional inertia," in that "it's easier to stay in the groove one is in."  In regard to alternative methods of infant feeding, cup-feeding and finger-feeding methods are less likely to interfere with the infant's skill acquisition at the breast, as compared to bottle-feeding methods.     

I would be grateful to hear of Lactnetters' experiences to the above question about infant preferences for various styles of artificial nipples, and will ask this question in a separate post as well.         

With best regards,

Debbie

Debra Swank, RN BSN IBCLC
Program Director
More Than Reflexes Education
Ocala, Florida USA
http://www.MoreThanReflexes.org

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