> I don't have any published documentation about red nipple use being a cause
> of poor oral development,

Nope, but they *are* a risk for premature discharge from the NICU within
(miss-)managed care. There are at least 2 hospitals in the Orange County
area of L.A. that simply do not order or stock anything BUT standard
nipples. The rationale makes sense: premies *can* suck "better" on the
red nipples (take in more if not all the feeding, have less feeding
intolerance as manifested in bradycardias, etc), but then their
insurance utilization review kicks them out of the hospital as being
"stable growing premies" when it couldn't be further from the truth.

 The red nipples convey a false sense of maturity. When the standard
yellow nipple is used from the get-go (laying aside the obviously better
nipple attached to mom, as already commented on), the premie is "able"
to demonstrate feeding intolerance and thus "prove" the need for ongoing
skilled nursing care and medical management. An unfortunate imposed
stress... In an ideal world, Dr. Marcovich would be their neonatologist,
have them BFing and home at this point...

Katharine West, BSN, MPH
Sherman Oaks, CA
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