Milk Flow Rates From Bottle Nipples Used for Feeding Infants Who Are Hospitalized Purpose This study tested the milk flow rates and variability in flow of currently available nipples used for bottle-feeding infants who are hospitalized. Method Clinicians in 3 countries were surveyed regarding nipples available to them for feeding infants who are hospitalized. Twenty-nine nipple types were identified, and 10 ... Research Article
Research Article  |   November 01, 2015
Milk Flow Rates From Bottle Nipples Used for Feeding Infants Who Are Hospitalized
 
Author Affiliations & Notes
  • Britt F. Pados
    School of Nursing, The University of North Carolina at Chapel Hill
  • Jinhee Park
    School of Nursing, Duke University, Durham, NC
  • Suzanne M. Thoyre
    School of Nursing, The University of North Carolina at Chapel Hill
  • Hayley Estrem
    School of Nursing, The University of North Carolina at Chapel Hill
  • W. Brant Nix
    School of Nursing, The University of North Carolina at Chapel Hill
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Britt F. Pados: bpados@email.unc.edu
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Katherine Verdolini Abbott
    Associate Editor: Katherine Verdolini Abbott×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Healthcare Settings / Research Articles
Research Article   |   November 01, 2015
Milk Flow Rates From Bottle Nipples Used for Feeding Infants Who Are Hospitalized
American Journal of Speech-Language Pathology, November 2015, Vol. 24, 671-679. doi:10.1044/2015_AJSLP-15-0011
History: Received February 2, 2015 , Revised May 25, 2015 , Accepted July 3, 2015
 
American Journal of Speech-Language Pathology, November 2015, Vol. 24, 671-679. doi:10.1044/2015_AJSLP-15-0011
History: Received February 2, 2015; Revised May 25, 2015; Accepted July 3, 2015
Web of Science® Times Cited: 4

Purpose This study tested the milk flow rates and variability in flow of currently available nipples used for bottle-feeding infants who are hospitalized.

Method Clinicians in 3 countries were surveyed regarding nipples available to them for feeding infants who are hospitalized. Twenty-nine nipple types were identified, and 10 nipples of each type were tested by measuring the amount of infant formula expressed in 1 min using a breast pump. Mean milk flow rate (mL/min) and coefficient of variation were used to compare nipples within brand and within category (i.e., Slow, Standard, Premature).

Results Flow rates varied widely between nipples, ranging from 2.10 mL/min for the Enfamil Cross-Cut to 85.34 mL/min for the Dr. Brown's Y-Cut Standard Neck. Variability of flow rates among nipples of the same type ranged from a coefficient of variation of 0.05 for Dr. Brown's Level 1 Standard- and Wide-Neck to 0.42 for the Enfamil Cross-Cut. Mean coefficient of variation by brand ranged from 0.08 for Dr. Brown's to 0.36 for Bionix.

Conclusions Milk flow is an easily manipulated variable that may contribute to the degree of physiologic instability experienced by infants who are medically fragile during oral feeding. This study provides clinicians with information to guide appropriate selection of bottle nipples for feeding infants who are hospitalized.

Acknowledgments
This study was funded by a Sigma Theta Tau International Honor Society of Nursing Alpha Alpha Chapter Research Award, awarded to Britt F. Pados, and was supported by the National Institute of Nursing Research under Award 5F31NR011262, also awarded to Britt F. Pados. The authors would like to acknowledge support provided to this project by the Biobehavioral Laboratory at the University of North Carolina at Chapel Hill School of Nursing. Nipples for testing were donated by Boston Children's Hospital, Duke University Medical Center, Floating Hospital for Children at Tufts University Medical Center, Groningen University (Netherlands), Handi-Craft Co., Medela Inc., North Carolina Children's Hospital, Royal Children's Hospital (Australia), and University of Oklahoma Children's Hospital.
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