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Tuesday, October 10, 2006

Nipple Sizes: Go with the Flow

The purpose of my blog is to give well informed advice, that I had to learn the hard way or research myself, to start a dialogue between you and your pediatrician. (Please note I am not a pediatrician.) It’s kind of hard for that to happen, if you didn’t know for example that most formula feeders don’t feed their babies for an hour. Why would you? In the hospital, I learned that many breastfeeders do feed for an hour. Take this formula-specific info and tell your child’s pediatrician that you heard that these are the signs that your child is ready to move to the next stage. What does she think?

The very first time I heard that nipples come in different flow rates, it was via a very judgmental comment from someone I know when I was still pregnant with my older son (OS). (This is not to be confused with the anecdote from my previous post when I completely freaked out that nipples came in “stages” and had to call my awesome cousin.) This conversation began when I was asked, “Can you believe that people are in such a hurry these days that they have to rush their babies when they’re taking a bottle?!!!” I had no idea that nipples came in “slow” “medium” and “fast”. I was horrified. Then I got judgmental too. “My child will always use the slow nipple,” I pronounced. I gave myself a little imaginary pat on the back, and I gave the imaginary enemy nipple with the gaping hole the evil eye. I could swear that I saw it lurking around the corner ready to pounce on me, or worse on OS. Thank goodness that person “saved” me from the horrors of the medium flow nipple!!! Yeah, that’s not what it means at all. Read on.

To review nipples come in 4 different stages:

  • Stage 1 (aka “slow”): this is for newborns. There is only one hole in this nipple so that the formula will come out very slowly. This is important because otherwise the newborn can choke. Any newborn bottle (translation small bottle) will come with this.

  • Stage 2 (aka “medium”): This for babies 3-6 months old and these nipples have 2 holes. Thus, the formula comes out faster.

  • Stage 3 (aka “fast”): This is for babies over 6 months. I never used these with my older son because we moved onto sippy cups, but presumably these nipples have 3 holes.

  • The Y-cut: This is a nipple where the hole is cut wide to so the baby can drink thicker drinks such as formula with a little bit of cereal in it.



    • If your baby is taking a long time to eat, you may want to think about moving up a stage. How long is long? I personally would begin that conversation with your doctor if he’s taken longer than 20 minutes and he’s no longer a newborn. That’s just me. If it seems like it’s taken a while to you, it’s definitely worth a phone call.

    The second way to know is if the baby seems frustrated when he’s eating. Does it seem like he’s sucking very vigorously and the formula is not coming out fast enough? Is he latching onto the nipple, sucking for a little bit, then letting go and crying out and subsequently repeating this cycle? These are very good signs that it’s time to move to the next nipple stage.

    How old is the baby? If the baby is between 3-6 months old, then he is the appropriate age (according to the packaging on stage 2 nipples) to move onto the next the level. It may, and I stress may, be time to think about moving to the next stage.

    How do you know if your baby is NOT ready? I can tell you this one from personal experience. OS at around 3 months was starting to show all the signs of being ready to move to the next nipple stage. At his 3-month check-up I asked the pediatrician if I could use Stage 2. She gave me the go ahead, and I switched him. OS looked very pleased (practically gleeful) when he began using stage 2. Yes, I know he was only 3 months old, so how pleased could he really be? He seemed much more relaxed when he ate. He wasn’t frustrated and he was able to swallow the formula easily without it spilling out of his mouth. With my younger son (YS), feedings were and still are taking a minimum of a half an hour. I got the green light from pediatrician again at the 3-month appointment with the caveat that he may not have developed his gag reflex yet in which case I would need to stay with stage I. I went ahead and switched to stage 2: YS hated/hates them. The formula comes spilling back out of his mouth. He cries. He doesn’t latch on for longer than a minute. He is not ready for stage 2 nipples. If your child is eating at a rate that’s okay with you and seems happy than by all means stick with what works!

    Other advice on nipples: Not all nipples are created equal. Some brands flow much faster than other brands. If your baby seems like he is ready to move ahead and you’ve gotten the okay from your pediatrician, but he’s having problems like YS has, I would try a different brand. In my personal experience, Playtex Ventaires (mentioned by J in a recent comment) flow very fast, for example.

    Here’s a tough one, and I call it tough because I have not experienced it with either of my children, I don’t know anyone who has experienced it, and I don’t know anyone who knows anyone who has experienced it. (If you know of any, your comments would be appreciated.) I have read, however, that because the formula comes out of the nipples faster, it is possible for the babies to overeat. However, your pediatrician should be suggesting a range for how much your child should be eating. If this does happen, one of the things you may be told is to go down a nipple stage so that the baby has to work at getting the formula just like how a breastfed baby has to work at getting the breastmilk.

    A. Elliot’s Lesson Learned: Take what you read here and start a dialogue with your child’s pediatrician about any concerns you may have.

    Labels: ,

    posted by Alex Elliot @ 4:39 PM   2 comments
    2 Comments:

    • At 10/12/2006 8:03 PM, Blogger bethandrobert said…

      We have the Medela Bottles and nipples (that came with the pump). DD has used them since her 4th week. At that point we just used a bottle a few times a week to be sure she would be used to them when I went back to work. We've never switched... she's 6 months old now and still using the same nipple (one hole). She eats from 5-8 oz in about 5 minutes. I don't know if that is fast or slow or what... but it seems to work for her!

       

    • At 12/02/2008 4:08 AM, Anonymous Kirsten Zee said…

      I didn't know that there's such thing as nipple sizes. I wasn't really aware til now how important this is. I always wonder if the surefire way is to put something like a nipple cover just as to alleviate the overflow. I should pay more attention next time for the benefit of my baby.

       
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    Name:Alex Elliot
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    About Me:Professional Mom of two cats, a dog, an ant farm, and oh yeah...two boys: a 6 year old and a 3 year old. Also found in my house is my husband who is known on this blog as The Big Giraffe.
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    For those of us who didn't get an instruction manual with our babies and for whom parenting hasn't always gone as planned. On a more serious note this blog is about supporting a woman's ability to make her own choices about parenting including the choice, for whatever reason, to bottle feed her babies formula.

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