<since this is similar to the shape of a nipple when
flattened on the roof of the mouth by the baby's tongue.>

This seems like circular reasoning to me. As I understand it, though
there was originally claimed to be research undergirding the development
of the orthodontic nipple, it was later found out that there was no such
research. It seems they simply patterned it after the "look" of nipples
after babies came off.

For years, in my teaching, I used the phrase "Nuk-look" to warn mothers
that if their nipples looked like that, the baby did not have a deep
enough "grasp".

I also referred to it as the nipple having a "peak" like a ball cap. I
later began hearing other people refer to this form of nipple trauma as
"the shape of a new lipstick", and I have adopted that term.

But for that very reason, according to my read of the recent JHL Kossing
article, a nipple with a rounded end is her recommendation. (Also a broad
base, although the one pictured in the article does not seem as broad as
others on the market.)

Way back when advising the Nuk was in vogue (I swallowed their
advertising hook line and sinker because it looked so authentic and
logical!), I did like the idea that the opening does release the milk
against the top of the palate area. (Many parents inserted it upside
down, in which case the milk is delivered into the surface of the tongue.
But might that have some slight value in the case of cleft-palate
babies?)

I suppose I recommended it because my experience was (and still is) that
a central hole often squirts a jet of milk straight back into the gag
reflex/nasopharyngeal area.

This results in "chuggalugging", the apparent "look how hungry the baby
is" misinterpretation that is really evidence of a stressful attempt to
breathe without choking while trying to coordinate sucking, swallowing
and breathing.

Kossing's point of holding the baby at a near 90 degree upright angle and
to be careful of the angle at which the bottle is held to reduce the
effect of gravity, along with the use of a "slow-flow" nipple, seems to
help avoid that.

I have even wondered what would happen if "blind" nipples (teats) were
bought, and holes place slightly down the side of the nipple to release
milk a little further forward rather than squirting at the throat. It
might at least avoid the shallow placement of the smaller part of the
nipple too far forward in the baby's mouth, as happens when many people
feed a bottle.

I think her article is very thought provoking and especially useful as
ammunition in retraining grandmas and baby sitters who are certain they
know all about how to feed a bottle!

Jean
***********
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html