Nipple Flow Rates: What are they really and how does this affect our clinical practice?

Written By: Lee Ann Damian, MA, CCC-SLP and Kaitlyn Johnson, MA-CCC-SLP

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Due to the FDA recommendations that were stated in late 2012 regarding the use of commercial thickeners (primarily Simply Thick) in infants; we were forced to re-think and re-assess our current practice of thickening infant’s liquids for improvement of swallow function based on these recommendations. As a result, use of slow flow nipples became popular to decrease flow rate with the hope of improving swallow function. It soon became apparent that “slow flow” was not consistent especially according to commercial packaging. This conclusion brought us to repeat and expand on the research of Kelly Jackman, MPT who published research on nipple flow rates in 2013 in the Newborn and Infant Nursing Reviews 13 (2013) 31-34. We chose to repeat the study with some minor adaptations to determine if there was consistency of correlation between methods. This information will provide an evidence based practice approach to nipple selection for slowing of rate to facilitate safe and efficient feeding. The information gained from the study was used to educate therapists, medical staff, nursing, and parents to aide in appropriate nipple selection based on flow rate and what is commercially available.