> That's one photo that I'd like to see, because it defies what I often find in my
> clients that use that bottle.
> 
> I can very easily go on a Cuban-tempered rant about this specific subject , so
> if you want my considered, professional tirade ::cough:: I mean, my clinical
> assessment email me privately, LOL.
> 
> In short, the picture you have just described (which I have not seen) is the
> exact OPPOSITE of what I see in many of my troubled (either sore or not-
> latching) clients.  Baby is most decidedly NOT taking that bottle with lips
> flanged around the broad base.  I only wish....
> 
> Regina M. Roig-Romero, BS IBCLC


Well, we don't really have research-based evidence to inform us re: the importance of that lip flanging on the teat and its role re: transition to/maintenance of effective, direct BF. In the teat trials a colleague and I are involved in, the thing that most affected flow was the exertion of the negative pressure (in conjuction with type, size, etc. of teat opening). Angle of bottle, etc. did not affect flow rate. Just as an FYI (abstract below), there was an interesting research report published last summer that demonstrates some of the issues with flow rate -- and it's role with airway protection and potential for improved compatibility with BF oral behaviors...
 
<< Goldfield EC, Richardson MJ, Lee KG & Margetts S (2006). Coordination of 
sucking, swallowing, and breathing and oxygen saturation during early infant 
breast-feeding and bottle-feeding. Pediatric Research, 60(4), 450-455. Epub 2006 
Aug 28. 
 
Children's Hospital Boston, Boston, Massachusetts 02215, USA. 
This prospective study compared the coordination of sucking, swallowing, and 
breathing and its relationship to oxygen saturation in infants during 
breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, 
infants began bottle-feedings of expressed human milk using one of two systems: 
a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and 
nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and 
oxygenation were measured during breast-feeding and bottle-feeding, and 
coordination of these activities during breast-feeding and bottle-feeding were 
compared. During breast-feeding, swallowing occurred nonrandomly between breaths 
and did not interfere with breathing. The same distribution of swallowing 
occurred in infants fed with system 1, while swallowing occurred randomly in 
infants fed with system 2. Swallowing significantly increased during 
bottle-feeding among infants using system 2, but decreased among infants using 
system 1. Infants using system 2 also had a greater instability in the 
coordination of sucking, swallowing, and breathing and more perturbation of 
breathing. Oxygen saturation was significantly higher in infants fed with system 
1 compared with system 2. These results suggest that the overall feeding pattern 
and oxygenation of system 1 are closer to the physiologic norm than system 2. >> 

Karen

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