Finding an Appropriate Bottle Nipple

Feeding is a nurturing and bonding process. Parents choose to bottle-feed exclusively or part-time for many reasons. This allows Dad and others to take part in feeding the baby. It can give Mom a much-needed break and allow others to connect and bond with the baby. Also, if Mom needs to be away from the baby for an extended period, the baby can continue to be fed on-demand or on schedule. If you bottle-feed your baby, review the information on paced bottle-feeding discussed earlier in other blogs.



Choosing an appropriate bottle for your baby can be confusing because there are many products on the market. You want a bottle nipple that fits your baby's mouth. If your baby has a small mouth, you will need a short, small nipple. A child with a larger mouth may be able to handle a longer nipple. In my opinion, it is better to give your child a nipple that is a little too short than one that is too long.

A nipple that is too long may encourage your baby to use incorrect movements that may negatively affect mouth development (such as tongue thrust or exaggerated tongue protrusion). If your baby has difficulty maintaining a good latch on the nipple, the nipple may be too long. If the bottle nipple is too long, it will often move in and out of your baby's mouth while your baby is drinking. This makes feeding inefficient and can tire your child.



There is a simple test to determine if nipple length is the problem or if your
The baby is having trouble getting enough pressure at the lips and inside the mouth to maintain the latch. Support your baby's checks during bottle drinking (see information on *maintaining a latch” in the next topic blog.). If the nipple stops moving in and out of your baby’s mouth while the cheeks are supported, nipple length is not the problem. You will need to provide your baby with cheeks supports until she learns to use the muscles of the jaw, cheeks, and lips to keep the latch.




However, if the bottle nipple continues to move in and out of your baby’s mouth when you give your baby cheek support, you need to find a nipple that fits your baby's mouth. Product labeling can be misleading. Your child may require a nipple that is labeled differently than you would expect. For example, some nipples are labeled preemie, newborn, or mini but maybe a perfect nipple size for your child. This does not say anything about your baby's development, except that she may require a certain nipple to appropriately fit her mouth. As the saying goes,” There is a key for every lock.” Finding the right key is important. Nipple shape can be another consideration when choosing a bottle for your baby. Many nipples are rounded so the tongue can cup around them. I prefer these because they encourage tongue cupping. This is particularly important for the newborn baby, who uses a deeply cupped tongue while drinking.

However, some babies drink better from what may be identified as an orthodontic nipple. These nipples may encourage up-down front tongue movement, which is typically seen as babies mature.

A good latch on the bottle means that your baby's lips maintain a hold on the "latch area" of the bottle nipple. The "latch area" is the part of the nipple that flares out from the nipple itself. A wide latch area may encourage better mouth development. However, more research is needed in the area of bottle-feeding and mouth development.

If your baby is using an appropriately sized nipple and still has difficulty maintaining a latch, your baby may have a jaw weakness or some other difficulty that you may not be able to determine on your own. As mentioned previously, providing your baby with cheek support can help your baby appropriately compensate for a weak latch until the difficulty is resolved. 



However, if you still have questions or concerns about the right nipple for your baby or your baby's latch on the nipple, work with a professional. Appropriately trained occupational therapists, speech-language pathologists, lactation consultants, nurse practitioners, and pediatricians can help you with this process. Check with the hospital where you delivered your baby or hospitals that specialize in feeding to find professionals who can help you. The International Lactation Consultant Association (www.ilca.org), the American Speech-Language-Hearing Association (www.asha.org), and the American Occupational Therapy Association (www.aota.org) are other sources for finding feeding
professionals.

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