[Dysphagia] RE: [asha-div13] Infant Feeding

[CShaker at covhealth.org (Shaker, Catherine S.)]

In researching nipples on the market, I have called manufacturers and
asked for the Research & Design Department's data about their nipples
labeled "slow flow" and have been consistently told "We don't have any
data. We just call it that".
I don't get the impression that there is a science behind much of what
is available on the market.

I try to observe nipples under video to get a somewhat evidence-based
impression of flow rate, versus using labeling or only what we see
clinically. The Dr. Brown's bottle appears to be fast flowing under
video, and I have seen it be more problematic for infants than helpful.
I find nipples labeled "slow flow" are often fast flowing when observed
under video.

I have observed under video that the Habermann feeder and the Gerber
3-hole nipple (surprising!) appear to have the most flow rate control,
which is often something I am looking for in the NICU, and for infants
coming for Swallow Studies. 

At one national NICU conference, it was suggested that we attach various
nipples to a breast pump and observe for variance in flow rate/amount
extracted over time. Haven't done that, but sounds interesting. What we
really need is a well-designed study to actually analyze flow rates of
at least the major current nipples used so we can make more sound
evidence-based therapeutic recommendations.

Catherine

Catherine S. Shaker M.S./CCC, BRS-S
Speech-Language Pathologist
Board Recognized Specialist in Swallowing and Swallowing Disorders
St. Joseph Regional Medical Center/NICU
5000 West Chambers Street
Milwaukee, WI  53210
Phone:  414-447-2797
Fax:      414-874-4104




-----Original Message-----
From: Julie Webb [mailto:webbj@email.chop.edu] 
Sent: Monday, February 07, 2005 2:35 PM
To: Division 13 Discussion List
Subject: [asha-div13] Infant Feeding


We have had a lot of parents reporting that once discharged from the
hospital they have had success feeding their infants with the Dr.
Browns' bottle system.  Just  wondering if anyone knew if the popularity
of this bottle could be contributed to any science or if it more related
to marketing.  Also, do you know the flow rates of the nipples you use
and recommend?  

Thanks Julie

Julie A. Webb M.A. CCC-SLP
Speech-Language Pathologist

Children's Hospital of Philadelphia
Center for Chilhood Communication
Department of Speech-Language Pathology
(215) 590-7634


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