Why Does Flow Matter to the Preemie in the NICU?
Imagine drinking milk through a straw versus from a firehose. Talk about a difference! Can you even begin to fathom how hard this would be? Would you choke? Cough? Potentially aspirate? Lose some (if not most) of the milk? You would be inundated by more milk than you could handle, and it would be pretty darn difficult to manage your food with how fast that flow is.
Now imagine a 34 week preemie learning how to coordinate sucking, swallowing, and breathing all at the same time. Most preemies have some form of respiratory distress, and when they can barely breathe to begin with, this makes eating on top of that extremely challenging.
Infants start showing hunger cues around 33-35 weeks gestation. These are signs that the baby is interested in bottle feeding and include:
· Rooting around (moving head side to side and searching for the breast)
· Opening their mouth
· Crying and fussing due to hunger
· Bringing fists to mouth and sucking on hands
· Aggressively sucking on the pacifier
Typically, we will start with the slow flow nipple when feeding by mouth and gradually work our way to the regular flow as the baby gets bigger and more coordinated.
In the NICU, we use various types of nipples and bottles when feeding our babies. Some of these include Dr. Brown’s bottles, regular flow nipples, slow flow nipples, Pigeon nipples, and orthodontic nipples. Finding the appropriate bottle/nipple for your baby depends on his/her condition and whether or not they are experiencing any feeding difficulties or challenges. Consideration of the infant’s oral motor abilities and neurologic maturity must also be taken into account when choosing which bottle to use. An occupation therapist and/or speech therapist will work with your baby to determine which bottle/nipple is the right fit for him/her.
The Dr. Brown’s bottle helps to reduce colic or excess gas.
The pigeon is a specialized nipple for cleft lip/palate babies.
The slow flow nipple is designed for the breastfed baby.
The regular flow is the standard nipple for most term newborns.
The orthodontic nipple is specifically designed to support the shape of a baby’s developing palate and jaw and reduce pressure on the gums and developing teeth.