At our most recent FLCA meeting we discused bottles/nipples and shared
frustration with marketing by one company- "most like mother". We felt this
company has done a good job with marketing since every mother in the United
States can quote their "line". However none of us have ever seen a nipple/
breast shaped like their system. We were wondering if they could provide a
photo of the breasts they used for their model or maybe we could all mail a
photo of the breasts we see as "really mother". Our meeting disintegrated
into laughter thinking of the marketing department receiving envelope after
envelope filled with photos of real breasts, I'm so glad we can still keep
our sense of humor!
       On the serious side we had an oral motor specialist  visit our meeting
last year that felt that a suck dependent flow was critical for infants who
were learning to suck. Her favorite bottles had a disposable bag. Members of
our group objected to the shape of the nipple which seems to encourage
sucking that is less like sucking at a breast than some other nipples. The
oral motor specialist encouraged all her clients to use this system to
improve sucking  but never had  nursing at the breast as a goal until she met
our group.  The last I heard, no bottle/nipple  was found that satisfied both
points of view completely.
      This specialist also shared the bit of info that the same brand of
nipples can have different speeds of flow in different manufacturing lots
(hole size can vary). There is no standard. Just recommending a --- nipple
does not insure a certain flowrate.
      I find in my practice that I recommend the silicone nipples based on my
opinion that taste is an important factor in returning to breast or accepting
a bottle-my kids think I'm funny when I try out the bottles. (part of my anti
formula campaign at home was "letting" my children try out ABM samples to see
which were tastiest). There is a taste/feel  difference between the latex and
silicone.
       I also feel the suck dependent flow is important in keeping babies on
track with the idea that sucking produces milk.
       I was interested in the thought of sensitizing infants to latex during
an oral assessment- what about all these babies sucking on latex/silicone
nipples for years?
                             Debby Kearney IBCLC-private practice in Orlando
and hating the fact I have to be an expert on artificial feeding too!