Hi Alicia et al:

I am paraphrasing and may not have this exactly correct but: in 1992 I
attended a conference session presented by M. Woolridge. He said suck
research (I believe via ultrasound exam) indicated that infants basically
suck the same on various teats UNLESS the teat continually drips (or is one
with a short shank). If a teat drips, the infant quickly learns to keep the
tongue back behind the lower gumline so that she can "push" up against the
dripping teat to stop the flow in order to take a breath (an aversive action
conflicting with appropriate breastfeeding behaviors and difficult to
extinguish due to "survival" relationship). With dripless teats, the sucking
or "milk stripping" action is essentially the same as with breastfeeding.
(Dr. Woolridge also expressed concern with infants becoming "hooked" on
finger feeding.)

Of course there are still problems with dripless teats: 1. baby barely has to
open the mouth to insert an artificial teat vs. latching onto breast and 2.
milk "stripping" does not need to wait for MER so there is "instant
gratification" for efforts.

I recommend an alternative to any artificial teat first, but if parent is
determined to use one for whatever reason, I'd rather inform them of dripless
no-flow varieties and slow flows if a transitional teat is needed, e.g. the
baby who's become used to a standard flow and becomes totally frustrated when
moved directly to no-flow (although I suggest giving no-flow a good trial
first). I inform parents that if they decide on using a bottle wth artificial
teat, even if the teat used may be better than some others, they probably
still are reinforcing behaviors counterproductive to breastfeeding which may
mean it will take longer to "solve" problem.

I also suggest and describe/demonstrate how parents can encourage infant to
latch onto teat and as deeply as she would to breast vs. inserting bottle
when baby's mouth is barely open.

I always suggest parents test flow as rates may vary. Teat brands I've tested
(1 1/2-2 oz. liquid in bottle with whichever teat) which appear to be
consistently dripless:

1. Playscool PUR 3-6 months--says "dripless" on package and appears to be
same proportion as newborn size.

2. J & J "Healthflow"--reports of teat collapsing when not used with crooked
bottle.

3. Haberman feeder--cost is prohibitive for most.


Ones I've tested as slow-flow:

1. Playschool PUR newborn "slow flow"--test individually as flow varies and
some drip faster than others.

2. Avent--test individually as flow varies and some drip faster than others;
difficult to find in our area; like the broad-base.

3. NUK--test individually as flow varies and some drip faster than others.

All of the above is anecdotal. I do think I have several clients who hung in
there and eventually breastfed because bottlefeeding with a slow or no drip
teat took pressure off of them while baby learned to breastfeed and/or mom's
confidence in her parenting and (pumped) milk production increased. Of
course, some continued breastmilk feeding vs. getting baby to breast and some
went totally to formula-feeding from a bottle. (One does one's best wheter an
LC or a mom!)

Karen