Hi Judy,

I wonder if, instead of a slower-flowing nipple, your hospital could explore other methods of temporary supplementation?  It sounds like the supplementation is only in special circumstances; perhaps finger feeding or cup feeding could be allowed/encouraged?  I only suggest this because it seems like the hospital where you work is open to spending money on something, why not something that better compliments natural feeding when there needs to be a supplement given?  Or are those doctors pretty set on bottles?  My (llimited) experience has been that for those babies, easy delivery of the supplement is necessary -- the babies might be sleepy or otherwise compromised (we are talking about sick babies if we're talking about phototherapy, assuming phototherapy is only being used when it's actually necessary) and a cup or finger feeder need not be a difficult mode of delivery.  

I know my first week with my first baby (very high bilirubin, among other things) would have been a lot different if the hospital staff had encouraged me to do something other than bottle-feed when we had to get that protein into little Anna.  I also think it's a lot easier in our society to view finger or cup feeding as a temporary situation...it is easy to "default" to bottle-feeding if that's what's being done from the outset.

And, while I'm thinking about it...I'd like to pose that all hospitals use only slower-flowing nipples for all (healthy) babies, whether they'll be breastfed or not!  I call the ones they use "Niagara Falls nipples" because, well, those poor babies can't handle the deluge!  Of course, if it's a baby that is compromised (premature, extreme jaundice, etc.), the slow-flow nipple might be too much work for the baby and might interfere with the feeding instead of enhance it.

Hope this helps, it's way too early for me and I'm thinking out loud!
Diana in NY (With an almost -year old baby waking every 90 minutes to nurse lately ...*sigh*)

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