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From: Automatic digest processor <[log in to unmask]>
To: Recipients of LACTNET digests <[log in to unmask]>
Sent: Tuesday, March 02, 2004 10:07 AM
Subject: LACTNET Digest - 2 Mar 2004 - Special issue (#2004-346)

I had my engineer husband help me figure out some of the differences in
bottles. All the bottle ads ( which is all we have to go on) say the same
thing: that their bottle and nipple are more like breastfeeding AND reduce
gas. This is what we found. The Dr. Browns bottle has a vent system that
connects the air in the bottle to outside air. Therefore, the air pressure
remains at atmospheric.  To get liquid from the bottle, the baby must use
suction. Compression does not move any milk. I tried using compression with
my fingers and the nipple just collapsed.

By contrast, the Avent bottle relies mainly on compression, as did the
Evenflow Elite. When the nipple is compressed, the air in the bottle is also
compressed, increasing pressure above atmospheric and forcing liquid out.
When the nipple is released, pressure is reduced below atmospheric, pulling
air into the bottle through the nipple. The Haberman feeder relies only on
compression because of the 1 way valve system. This explains why some babies
do better on one bottle/nipple than the other. It depends on how the baby is
feeding. Of course, breastfeeding is a combination of suction and
compression. Some babies have difficulty with one thing or the other,
depending on their anatomy and physiology. Things like tongue tie,
prematurity, hypotonia,and clefts,etc affect babies' feeding skills. While
breastfeeding is the ultimate goal, it is also helpful to understand all the
feeding alternatives like SNS and bottles. It is not helpful, for example,
to have a baby using a bottle that he or she cannot move milk efficiently or
becomes overwhelmed by.  Cleft palate babies need bottles like the Haberman
because they are unable to creat suction.Dee Kassings' article in JHL is one
example of using a bottle and nipple to promote breastfeeding. I have
learned some interesting details about feeding from OT's and speech
pathologists, too.

It would be interesting to have bottle/nipple manufacturers explain their
products and respond to questions from a professional group of LC's and
OT's. I see these products as useful for intervention (as are other aids)
when supplementing is absolutely necessary. It is important that we know as
much as we can about these interventions.
Ann Anderson IBCLC, NJ.

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