Preemie Nipple Use with Older Infants?
The unintended consequences of the extended use of preemie flow rate bottle nipples to support breastfeeding by Allyson Goodwyn
There is a popular belief among many healthcare professionals and social media support groups that breast fed full term infants who require bottle supplements should use a preemie flow rate nipple. It sounds logical, with a very slow flow nipple the infant must suck harder to pull the milk from the bottle, thereby, strengthening their suck and ensuring bottle feeding is not “easier” than breast. This may be helpful in the first four weeks as breast feeding is being established; however, extended use of preemie flow nipples can result in unintended consequences by teaching compensatory suck patterns.
read more here https://www.feedingmatters.org/blog/preemie-nipple-use-with-older-infants
Molly J says
Interesting article! My question is, aside from the subjective, visual evidence to imply that there is increased energy expenditure with a preemie nipple, is there any validated evidence/instrumental assessment that has studied energy output or the correlation between prolonged preemie use and failure to thrive? Seems like a scary connection to make based on assumption alone that increased fatigue must ultimately result in poor weight gain/FTT. Thanks!
Ann Marie says
Thanks. Interesting and well done, Allyson. I often find young infants struggling to feed are placed on faster flow nipples, which can cause a lot of issues. I like the time frame Allyson references. I think many parents feel feeding time should be much quicker than it actually is for the young infant. The faster flow (even if it says slow flow, as she referenced) is a good point and I’ve found it to cause the “popping” or “clicking”/loss of seal bc the child is using compression to slow the flow. Once the flow is slowed, for many the clicking reduces. Some need the preemie but some need the level 1 or another slow flow bc the preemie is indeed too hard. Clinically I do find the preemie flow extremely helpful for some young infants- love the nipple :). Like anything in feeding, it’s based on the individual infant. I agree there should be clinical analysis to see when the suck:swallow ratio is too high to make the switch to the level one or another nipple that will support the individual case, especially as the child gets older. Wanted to share that thought that came to me as I read. Thanks for the article.
Patricia Boyle says
Really good article is about full term infants breastfeeding. I have followed a fair number of fragile very preterm infants home with significant comorbidities (neuro/respiratory) who continue to use the preemie nipple as they transition to full breast feeding and they simply cannot use faster flow nipples. An individual approach is always best with these kiddos. I do think this is excellent information. We often give preemie nipples to full term infants learning to breast feed in the NICU. The hope is that it facilitates transition to exclusive BF. However, good info and we as feeding specialists should include this information when educating families as they discharge home. I can see as mom’s milk supply gets established the infant can use these compensatory movements to transfer milk out of a bottle nipple that doesn’t match mom’s established flow. Thank you for posting the article Krisi!!