What's the big deal about a bottle nipple?



One of the most common questions I hear from moms planning to breastfeed is: which nipple/bottle is best for baby? 

Worst fear: the baby will not take any nipple except mom’s

Almost always the answer is: the one baby will take. Some babies are picky; some are not. You never know ahead of time. The very fact that there are so many choices out there says there is no one right answer.

Let's look beyond the usual answer for a moment.

Given: the more closely an artificial nipple can match the baby’s experience with mom, the better.

When a baby is feeding at the breast, he is using a combination of forces to help move the milk into his mouth. One type of force is suction or vacuum; another is massage or compression. 


The baby’s suck helps move mom’s nipple into place in the his mouth and hold it there; plus, there is a point right at the end of the suck-swallow movement where a vacuum is created in the back of the baby’s mouth. During the first few days of breastfeeding, it is this kind of suction most moms are so aware of: "Wow! This baby has a strong suck!"


With mom’s nipple in place, a baby’s tongue extends across his gums, pushing his lower lip out of the way. He uses his tongue and lower jaw to massage mom’s breast and compress it against the roof of his mouth. This helps the milk move out of mom’s breast and into his mouth. 

Given: many if not most bottle nipples will drip milk when held upside down even if there is no pressure or suction applied to the nipple. When a baby applies the suction and massage he is used to doing, he may get a much faster flow of milk than he wants. One way to cope is to quit applying much suction or massage. 

Here we meet up with a mom’s next worst fear: baby won’t go back to breastfeeding. He has learned a different way of getting milk. Will he remember both? Which will he prefer? Can we make the experience more similar so he doesn’t have to switch his style so much?

Back to the discussion of nipples. There are two unique nipples available now, each with a different take on what will make the bottle-feeding experience closer to the feeding-at-breast experience.

Calma from Medela. Just released in the US this month, the Calma has been available elsewhere long enough to develop significant word-of-mouth buzz. This research-based nipple system has a valve design that will not allow milk flow without suction. If you hold it upside down, nothing happens. The nipple itself has a startling 1/4” opening. The baby controls the flow by applying suction.

Breastflow from First Years. This nipple is a nipple-within-a-nipple. The exterior nipple is a common looking wide-base silicone. Inside is another, denser nipple. Because of the shaping and fit of these two nipples together, the baby gets more milk by applying more compression to the outer nipple.

Most babies will eventually go back and forth between bottle and breast with ease. A few babies will have a nipple preference. And some babies may really need one or another of these nipples to be able to make the transition easily. It is for those babies the choice of a nipple can be a really big deal. More questions about nipple choices? Stay tuned.

Breastfeeding Research

The Jan/Feb 2012 edition of the American Journal of Maternal Child Nursing, has published a study looking at Interruptions to Breastfeeding Dyads in an LDRP Unit.   Doors to the rooms of 30 breastfeeding moms in a hospital birthing center were monitored from 8AM to 8PM on post-delivery day 1: mothers were interrupted an average of 53 times in that 12 hour period.  The 18-minute average interruption was longer than the average 15-minute stretch of time alone with the baby.