To Loni Denman:

For a mom who feels that a bottle is the only way she can feed her expressed
milk while working to help her baby to latch on, I find that the Avent newborn
nipple (and Mom has to buy the bottle to go with it!) works well.  The wide
base of the nipple helps the baby keep its jaws open wider than with the
standard Evenflo-type nipple.  The flow is slow, so the baby doesn't have to
"swallow or drown."

I've never had any proof that the Nuk nipples offered any benefit over other
designs.  The ads aren't "scientific and factual" enough to convince me!  Same
for Playtex nurser---I've found that when a baby doesn't know how to latch on
to the breast, he can't figure out how to latch on to the Playtex either.  He
just gnaws on the little button-shaped nipple and gets milk that way, learning
nothing about breastfeeding technique.

One other teat I've heard recommended by someone I trust is the Munchkin.

I've also had success with the Avent for babies who "won't take a bottle" when
Mom goes to work at 3 or 4 months.

The feeder should try to help the baby use as many of the normal "breast-
approach behaviors" as possible.  By that I mean 1) position the baby well
supported, hips slightly flexed, head slightly extended; 2) offer the nipple
(or feeder's hand or finger) to touch lips or face and elicit gape; 3) gently
move baby and bottle together, trying as much as possible to help the baby
"take" the bottle, not shoving the bottle into the baby's mouth; 4) assess for
tongue wrapping the nipple underneath, wide open jaws, and flanged lips; 5)
hold bottle pretty still and let baby control the rate and rhythm of sucks and
pauses.

There's more to bottle-feeding than just selecting the right teat.  I once
read a rather cynical description of the typical hospital nurse's bottle-
feeding technique as the "deep throat, gag and vomit" school of feeding.  I
was a hospital nurse at the time myself---and I was in total agreement with
that observation.

Chris Mulford