[Dysphagia] [asha-div13] new Enfamil nipples

[Catherine.Shaker at wfhc.org (Shaker, Catherine S.)]

I have always found the standard single hole Enfamil nipple to run
faster (have a higher flow rate) in Radiology.
Our nursery doesn't stock them per nursing preference as well.
 
The Enfamil slow flow nipple recently released has worked well for our
neonates, and I hear similar positive reports as I teach around the
country.
 
I spoke with the Mead Johnson/Enfamil research and design department,
and there is 12 years of research behind this nipple apparently---which
is not typically the case. Most nipples on the market have no research
back up for being labeled  "slow flow". When I have asked the companies
for their research, I have typically been told "oh we don't have any
research,we just call it that!" I do wish Enfamil had not made the slow
flow nipple as soft as it is; I was told by R&D that it was based on
nursing's request for a soft nipple. The proprioceptive input from a
firmer nipple seems form my experience, to enhance intrinsic tongue
control.
 
Regarding impact on feeding times, taking longer to feed is not
necessarily a bad thing; for many of our babies, it helps improve
coordination when the bolus size is smaller or the flow is more
manageable.  I have yet to find a baby where a faster flow or faster
feeding really enhanced the safety and integrity of the swallow.
 
I also explain to nurses that a slow flow nipple doesn't mean it is
harder for baby to get the fluid out, or that he has to "work hard"; it
means a smaller bolus is delivered with each suck.
 
Hope this helps, Taryn!
 
Catherine

Catherine S. Shaker M.S./CCC-SLP, BRS-S 
NICU Swallowing/Feeding Specialist

Manager - Pediatric Rehabilitation 
Wheaton Franciscan Healthcare - St. Joseph 
5000 West Chambers Street 
Milwaukee, WI  53210 
414-447-2797 Phone 
414-874-4104  Fax 
Catherine.Shaker at wfhc.org 

 


________________________________

	From: Taryn Rogers [mailto:tarynlee17 at hotmail.com] 
	Sent: Wednesday, June 06, 2007 12:10 PM
	To: Division 13 Discussion List
	Subject: [asha-div13] new Enfamil nipples
	
	

	Hi all,
	Recently Enfamil replaced their standard single-hole nipple and
premature nipple with new softer versions of the nipple.  For those of
you that use these nipples in your pediatric hospitals, what has your
experience been with them?  We are finding that they the new nipples are
not comparable to the older versions and feedings are actually taking a
little longer.  Under fluroscopy, neonates and infants are performing
very differently between each of the nipples.  Any observations you have
made would be helpful.  We recently had a meeting with our Mead
Johnson/Enfamil representatives to discuss this.  Thanks!
	 
	-Taryn Rogers, M.A., CCC/SLP
	CT Children's Medical Center
	
	
	 

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