Impact of venting, caloric density, and formula type on flow rates from bottle nipples
In this study, I examined the impact of a venting system, the caloric density of infant formula, and the type of infant formula on flow rates from bottle nipples.
Authors: Britt Pados
Publication Information: Journal of Neonatal Nursing. Online ahead of print. doi: 10.1016/j.jnn.2023.10.005
This paper is available free and open access on the publisher’s website until December 23, 2023, click here.
Promoting your scholarly work to increase awareness and impact
In this guest Editorial, I share ideas for promoting your scholarly work to increase awareness and impact. I give examples of how I have used social media to share my work related to flow rates from bottle nipples.
Authors: Britt Pados
Publication Information: Advances in Neonatal Care. 2022; 22(1): 1-2. doi: 10.1097/ANC.0000000000000977
This Editorial is available free and open access on the publisher’s website, click here.
Assessing the flow rate of different bottles and teats for neonates with feeding difficulties: An Australian context
In this study of 27 different types of bottle teats (N = 405) used to feed infants in Australia, we found significant differences in flow rates between teats. For example, within bottle teats labeled “slow flow,” there were significant differences in flow rates. These data can be used to guide clinical decision-making around teat selection when feeding medically-complex infants.
Authors: Jeanne Marshall, Sally Clarke, Catherine Escott, & Britt Pados
Publication Information: Journal of Neonatal Nursing. 2020; 27(4): 285-290. doi: 10.1016/j.jnn.2020.11.014
Milk flow rates from bottle nipples: What we know and why it matters
Existing studies on milk flow rates have indicated that flow rate varies widely among different types of nipples. Within the same type of nipple, there can also be significant variation in flow rates from one nipple to another. Factors such as type of milk, preparation of milk, and thickening of milk can impact flow. Altering flow rate is a simple intervention that can be used to improve safety of feeding in young infants. Data from existing studies should be used to guide decision-making around nipple selection in infants who are medically complex or struggling to feed. Infants should be fed with a flow rate that allows them to feed safely and efficiently; there are no data to support the need for infants to feed with a standard-flow nipple prior to discharge.
Authors: Britt Pados
Publication Information: Nursing for Women’s Health. 2021; 25(3): 229-235. doi: 10.1016/j.nwh.2021.03.006
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Effect of formula type and preparation on International Dysphagia Diet Standardisation Initiative thickness level and milk flow rates from bottle teats
In this study we compared IDDSI thickness levels and flow rates between the powder and the ready-to-feed formulations of following infant formulas: Similac Advance, Similac for Spit-Up, Enfamil Infant, and Enfamil Anti-Reflux (A.R.). We found that Enfamil A.R. ready-to-feed formulation was IDDSI “slightly thick” while the other formula types and formulations were all IDDSI “thin” liquids. The standard infant formulas (Similac Advance and Enfamil Infant) had comparable flow rates regardless of whether they were the powder formulation or ready-to-feed formulation. The gastroesophageal reflux (GER) specific formulas (Similac for Spit-Up and Enfamil A.R.) had slower flow rates than the standard formulas. Within the GER-specific formulas, there were differences in flow rates between the powder and ready-to-feed formulations.
Authors: Britt Pados & Victoria Feaster
Publication Information: American Journal of Speech-Language Pathology. 2021; 30(1): 260-265. doi: 10.1044/2020_AJSLP-20-00272
Effect of thickening on flow rates through bottle nipples
In this study we tested 7 different types of bottle nipples with three different thicknesses of formula (thin, slightly thick, and mildly thick). As expected, increasing thickness resulted in decreased flow rate. Thickening also increased the variability in flow rates. These data can be used to guide clinical decision-making around nipple selection when thickening is needed.
Authors: Britt Pados & Megan Mellon
Publication Information: Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2021; 50(1): 78-87. doi: 10.1016/j.jogn.2020.09.153
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Know the flow: Milk flow rates from bottle nipples used in the hospital and after discharge
In this study, we tested 25 different types of bottle nipples available in the United States (N = 375) for milk flow rate and variability. We found that milk flow rates varied widely, from 0.86 to 37.61 mL/min. Variability of flow rates within each nipple type also varied widely. Package label information often was not an accurate reflection of flow rate. These data can be used to guide decisions regarding nipples to use for feeding infants who are at risk for or experiencing feeding difficulties.
Authors: Britt Pados, Jinhee Park, & Pamela Dodrill
Publication Information: Advances in Neonatal Care. 2019; 19(1): 32-41. doi: 10.1097/ANC.0000000000000538
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Milk flow rates from bottle nipples used after hospital discharge
In this study, we tested 26 different nipple types (N=260) that represented variety in price per nipple and store location sold. Milk flow rates varied from 1.68 mL/min for the Avent Natural Newborn Flow to 85.34 mL/min for the Dr. Brown’s Standard Y-cut. Variability between nipple types also varied widely, from .03 for the Dr. Brown’s Standard Level 3 to .37 for MAM Nipple 1 Slow Flow. These extreme ranges of flow rates suggest that nipple selection may be of critical importance for infants who are continuing to develop their oral feeding skills. Variability in flow rates within nipples of the same type may complicate learning to orally feed in infants with medical complexity. Product package labels do not provide clear information about flow rate to guide clinicians or parents in their decision-making.
Authors: Britt Pados, Jinhee Park, Suzanne Thoyre, Hayley Estrem, & Brant Nix
Publication Information: The American Journal of Maternal/Child Nursing. 2016; 41(4): 237-243. doi: 10.1097/NMC.0000000000000244
This paper is available for free and open access through PubMed Central, click here.
Milk flow rates from bottle nipples used for feeding infants who are hospitalized
In this study of 29 different nipple types (N=290), we found that flow rates varied widely, ranging from 2.10 mL/min for the Enfamil Cross-Cut to 85.34 mL/min for the Dr. Brown’s Y-Cut Standard Neck. Variability of flow rates among nipples of the same type also ranged widely. This study provides clinicians with information to guide nipple selection for infants who remain hospitalized.
Authors: Britt Pados, Jinhee Park, Suzanne Thoyre, Hayley Estrem, & Brant Nix
Publication Information: American Journal of Speech-Language Pathology. 2015; 24(4): 671-679. doi: 10.1044/2015_AJSLP-15-0011
This paper is available for free and open access through PubMed Central, click here.