I'm sorry, but this is so wrong. This is just asking for aversion after aversion.
"Spilling milk out of her mouth" is anterior loss. It's showing that the baby is not tolerating the flow of the feeding. The feeding is coming out of the nipple too fast, the baby is pushing it out. It's also a sign that that feeding should cease. If it continues, the baby is eventually going to get worn out and aspirate, because it will be too exhausted to push it out any longer.
Secondly, arching, crying, pushing away from the nipple, falling asleep, etc., with a feeding are also signs that the baby is done eating. That baby is cueing that the feeding is no longer wanted... I wonder why. The faster flow is probably stressing the baby out more, probably exasperating the PPHN.
This is a 25 weeker, who is 42 weeks, on oxygen, and have mild PPHN. If we are even going to orally feed this kid, it BETTER be slow flow, probably with a thickener.
ALL of our premature babies are fed with a slow flow nipple, and most term kids are as well, all the way to discharge, and we send parents home with a slow flow bottle and nipple, to continue using. ALL of our premature babies are held in a left-side lying position, elevated. Many of our kids are paced, if it's needed.
The order needs to be deleted from use. The kid is in the NICU for a reason, and doesn't need to aspirate, in which case they are at higher risk for if they have had any respiratory problems. The few kids that could probably use standard flow nipples are the chorio kids that just need some antibiotics and haven't had any respiratory problems.
The SLP is not educated on neonatal feedings, obviously. I'd rather not have a kid that has mild PPHN to aspirate, thanks. Slow flow nipple is NOT harder to get out of the nipple, it's to literally SLOW THE FLOW. These kids SHOULD eat slower, so they DON'T aspirate. If the baby is worn out, then the feeding is done. If the baby isn't meeting their full feeds, then you need to tube feed, to meet those requirements. Obviously this is an ongoing problem, seeing as the baby is 42 weeks, in which case, I wouldn't be surprised if the baby needs a button to go home.
My suggestion - Lobby for a SLP full-time in the NICU that knows what they are talking about.