Milk Flow Rates From Bottle Nipples Used for Feeding Infants Who Are Hospitalized

Written By: Britt F. Pados, Jinhee Park, Suzanne M. Thoyre, Hayley Estrem, and W. Brant Nix

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Feeding can be physiologically challenging for pre-mature and medically fragile infants who are learning to feed orally. Whereas breastfeeding may be the ultimate goal, most infants who are hospitalized will receive some bottle-feedings. Many variables contribute to an infant’s ability to bottle-feed safely and effectively, but one easily manipulated variable is the rate of milk flow from the bottle nipple. Milk flow is defined as the rate of transfer of milk from the bottle into the mouth during sucking. The rate of milk flow can affect an infant’s ability to integrate fluid management with respiration, as well as the degree of ventilatory compromise associated with feeding (al-Sayed, Schrank, & Thach, 1994; Mathew, 1991a). When an infant swallows, the airway is closed for about 1 s to prevent aspiration of milk (Mathew, 1991b). As milk flow increases and requires increased swallowing frequency, ventilation is increasingly interrupted and respiratory rate decreases (al-Sayed et al., 1994). When milk flow slows, the swallow is delayed until a critical volume is accumulated (al-Sayed et al., 1994), allowing the infant to breath more frequently and better maintain physiologic stability during feeding.