Are other units jumping on the Dr. Brown nipple train? My unit is no longer stocking disposable nipples, so everybody gets a Dr. Brown.
We've had some issues with them not being cleaned sufficiently, which is super gross. Our coordinator recently sent out an email saying that 'milk scum' had been found in the crevices of several bottles that had just been 'sterilized' in the microwave sterilizer bags. It kind of makes sense, though: if you've got three feeder-growers who PO q 3, and you take five minutes to adequately wash the bottle after each feed, that's exactly 60 mins spent washing bottles per shift--ain't nobody got time for that!! I'm not all that surprised that nurses are cutting corners, even though that's a huge, nasty infection risk. I've also had some nipples that were not rinsed sufficiently, and so the baby would make a grossed-out, scrunched-up face and reject the bottle (I would too, if it tasted like soap). Surely, that kind of negative stimulus must not be helpful when it comes to the development of oral aversion.
To be fair, I went to a neonatal feeding conference where the speaker presented research which found that Dr. Brown nipples are actually the best for the babies. Apparently most nipples are pre-made, and the appropriate sized hole is stamped in the middle depending on flow rate; the holes can close up over time, which means that an old standard-flow may actually be slower than a brand new slow-flow. Meanwhile, the Dr. Brown nipples are apparently built around the hole, so it never changes size and the flow is more consistent.
I get that some kids seriously do need a Dr. Brown nipple since the disposables aren't working out for them. However, my current hospital is doing it specifically as a cost-saving measure (since one Dr. Brown bottle costs about $5 and can be reused, whereas the disposables are apparently around $1 each).
If every kid gets a Dr. Brown, it would be nice for units to hire someone who is solely responsible for washing the d***ed nipples, since it seems unrealistic to squeeze an extra hour of work to an already busy 12 hour shift.
Most units wouldn't have the room or hookup for a dishwasher, and I wouldn't trust central supply to not lose or ruin them. You should be sterilizing them in the bag they come with once every 24 hours.
I hate Dr. Browns and I think the whole silly contraption doesn't do a damn thing to limit air swallowing. We have brushes to clean parts and we have bags so that we sterilize them each night. I had no idea they had one use ones that don't include that idiot contraption in the middle.
I totally agree! Its almost like the hospitals are getting them for free or something.. It seems like I blinked and suddenly every baby has a Dr. Brown bottle. There are definitely benefits to bottle system, but infection risks definitely cannot be ignored.
In the two different hospital NICUs I have had experience with, neither used DB unless kiddo had been assessed by either OT or Speech Therapy and it was determined a necessity. In both places, the parent/s were responsible for taking apart and washing each piece of the contraption. We provided dish soap/washing bin. But we the staff were not allowed to wash the contraptions since it was a "liability issue" if they were not cleaned properly.
I'm not all that surprised that nurses are cutting corners, even though that's a huge, nasty infection risk. I've also had some nipples that were not rinsed sufficiently, and so the baby would make a grossed-out, scrunched-up face and reject the bottle (I would too, if it tasted like soap). Surely, that kind of negative stimulus must not be helpful when it comes to the development of oral aversion. 
NicuGal, MSN, RN
2,743 Posts
Most units wouldn't have the room or hookup for a dishwasher, and I wouldn't trust central supply to not lose or ruin them. You should be sterilizing them in the bag they come with once every 24 hours.