“How does a Dr. Brown’s® bottle actually work and what benefits does it provide for infants with immature oral feeding skills and infants with significant feeding challenges?”
This IS the number one question from Dr. Brown’s® Medical product users. It is second only to two similar questions which include: what is the biggest difference between using a Dr. Brown’s Natural Flow®, vacuum-free bottle system versus using a standard bottle system (i.e. a disposable bottle and nipple)? And thirdly, isn’t the biggest difference of Dr. Brown’s® bottle systems in the nipple flow rate and not the bottle?
These are great questions and due to the seemingly increase in frequency of these questions, this month’s Clinical Spotlight topic was chosen to shine the light on two valuable research studies providing clarity on these very significant clinical questions. Both studies are chock full of amazing insight and information related to neonatal feeding practice. After reading, they will impact your future clinical decision making, specifically when selecting a bottle system for an infant’s initial feeding experience as well as infants with feeding challenges.
In the first article, Fucile et al. (2009) study results revealed that a controlled-flow vacuum-free bottle system (Dr. Brown’s® bottle system) versus a standard bottle facilitated overall transfer, rate of milk transfer, and shortened oral feeding duration in VLBW infants. Further, they suggest that the use of a controlled-flow vacuum-free bottle system may reduce energy expenditure as it enhances feeding performance without increasing sucking effort.
In the second article selection, Lau, et al. (2015) “confirms the advanced hypothesis that VLBW infants’ improved oral feeding performance was associated with more mature oral feeding skill when fed with a self-paced bottle (without hydrostatic pressure – Dr. Brown’s® bottle system) versus a standard bottle system (with hydrostatic pressure). Further, they propose that the benefit of the vacuum-free bottle system was a direct result of the elimination of hydrostatic pressure and internal vacuum build up that are present in standard bottle systems as fluid is removed during oral feedings.” (Refer to Figure 2 in this paper to view a tracing of the internal vacuum build up within a standard bottle during feedings.)
Importantly, Lau and colleagues stated that given the results of their study that “the century-old feeding bottle may no longer be appropriate” as their work clearly “highlights the importance of using appropriate tool(s) that take into account the pathophysiologic and/or maturational limitations of the infant in order to optimize their oral feeding performance and that the optimal feeding tool should be designed to support the infant’s functional limitations. “The presence of the hydrostatic pressure and vacuum build-up physically occurring in standard bottles currently in use hamper the feeding performance of VLBW infants and put infants at a disadvantage likely causing some of their oral feeding issues”.
Both studies are chock full of amazing insight and information related to bottle feeding science! After reading and reflecting, they WILL assert a strong impact on future clinical decision making, specifically when selecting a bottle system for an infant with feeding challenges.
The number one question may now be: Why “wouldn’t” you chose a Dr. Brown’s Natural Flow® vacuum-free bottle to feed your most fragile patients especially those with feeding challenges?