Diana notes the most important reason for avoiding brand names - companies
are constantly changing or "improving"(!) them. A company may change
vendors, the size, the shape, the hole size or placement -- accidentally or
on purpose. (In general, I think it's on purpose to reinforce a need for the
product and/or to save production costs.)

There are no standards in the USA and I'm unaware of any in other countries
for what a company puts on a label/package for feeding bottles and/or
related nipples/teats. What does "slow flow" mean - NOTHING. (It may mean
slower than the company's next level of nipple/teat, but even that isn't
necessarily so.) What does it mean to insert the word "breast" as part of
the product's name or claim it's "most like breast" or something similar -
NOTHING.

If we all lined up (perhaps at an ILCA Conference) and lifted our shirts,
there would be no one "like breast" -- we come with all kinds of workable
breast/areola/nipple sizes, shapes, protractility, etc. (So whose breast did
all those whacky companies use to model their feeding-bottle nipples/teats
on?!?) And it's absolutely impossible to recreate the very active oral
behaviors a baby must coordinate to draw in the breast, form the teat,
create a seal, then use the tongue in several different ways, etc. via the
fairly passive oral activities associated with feeding from a bottle with
nipple/teat. (It's interesting that bottle-feeding is associated with
sucking when most feeding-bottle nipples/teats are so fast that babies must
(and can) use compression if they are to obtain liquid but still have enough
control of the bolus. Yet it wasn't that long ago when we thought
compression played more of a role in removal of milk at breast...)

There are no standards so any company can claim their nipple/teat can do or
be anything. They can change something, give it some slightly different name
and proclaim it as "new and improved." Or they can quietly change something,
e.g. the manufacturer, material, etc. and say nothing about the change.

No nipple/teat-testing data is worth much within 1-2 years of the test. A
colleague and I tested lots of bottle nipples in the last few years via a
breast pump -- happy to share process but it's impossible to keep up with
them. Recently, we've had some negative parent feedback on one we'd found to
be more compatible with wave-like sucking -- babies having behaviors
associated with faster flow, which leads to (mal)adaptive feeding behaviors
to accommodate breathing. Things change and the feedback is leading me to
believe a quiet change has taken place for another nipple/teat...

Fortunately, we don't really need the data. It's possible -- and better --
to read the baby vs any nipple/teat data. Babies "tell" us when they're
having difficulty with shape, length of teat, material of teat, etc,
although there's no real data on those aspects of bottle-feeding. And they
tell us when a teat is too fast flow, forcing them into airway protective
(and contradictory to breastfeeding) oral behaviors. (There is LOTS of data
on effect of flow rate.) Baby chokes, gags, coughs, sputters, etc --
obviously too fast. Baby clenches/bites on nipple/teat (to halt flow to give
self an opportunity to breathe) or drools a lot (lowering oral tone to
"lose" some of the bolus in order to handle bolus with breathing) or
demonstrates aversive behaviors (turns or tries to turn head to side or bats
at feeding bottle with hand/arm in uncoordinated slow mo) -- saying "too
fast" in more subtle ways.

Sorry to ramble but it frustrates me when parents believe something simply
because some slick marketing campaign aligns their nipple/teat product with
the breast. And it frustrates me that there are so few appropriately
slow-flow feeding-bottle nipples/teats to use when a newborn or young baby
needs supplementation and stressed parents reach for the culturally
familiar. Not to mention it frustrates me to hear about nursing strikes in
the over 3 month old who has been "graduating" to ever-faster bottle nipples
and then mothers wonder why they strike.

Bottom line - (all this and you could've just jumped to the end) -- Read the
baby -- not the product label or the data -- and teach parents how to do so.
(And once the appropriate slow-flow nipple/teat is found, never let it go.
Forget "graduations" to faster flow.)

It's late - hope this makes sense!





> Date:    Mon, 14 Feb 2011 13:14:11 -0500
> From:    "Diana West, IBCLC" <[log in to unmask]>
> Subject: Re: Medela Calma teat
>
> >maybe the BFAR/Lowmilksupply.org people are doing some more bottle
> >research???  (nudge nudge...)
>
> We haven't ever done any -- Lisa and I just posted our opinions (now
> dated and badly in need of updating) of optimal nipples for
> supplementation on the lowmilksupply.org site.  My to-do list is very
> long, but updating this is on the list, so if anyone has any opinions
> or new research to point me to, please feel free to send them.  Do
> note, though, that I'm going to try to avoid brand names at
> all.  They change too frequently and are not available globally.
>
> Diana
>
>
>             ***********************************************
>
>

-- 
Karen Gromada
www.karengromada.com/

             ***********************************************

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