Preemie Nipples

Specialties NICU

Published

My unit will not send a baby home until they can use a term nipple, but I see preemie nipples for sale all over? What are your guidelines? Do you send babies home using preemie nipples?

Specializes in NICU.

On our unit we use slow flow nipples on all preterm kids and some term kids. I think (can't remember exactly) that the medium flow nipple packages are labeled for something like 3-6 months of age. Slow flows are designed for newborns and preemies. They have to suck harder to transfer milk, which may cause them to expend some additional calories. :( But, the flow on a medium flow nipple is more than most kids can properly accomodate. So many of them end up bathing their bib or choking or both with the medium flow. But, if the kid is pretty coordinated but has a weak suck, we might try a medium flow nipple so they don't have to work so hard. Bonus for the slow flow is that it is closer to the amount of suction they will need to transfer milk when breastfeeding--so this will hopefully help them develop the strength of suck they will need to transition well between bottle and breast.

i work in an nicu unit with many preemies. we have used premature nipples for years with premature infants with a decreased intra oral suck pressure,and they have all done well w\out any problems transitioning to a term nipple. latey, an issue has been brought up that premature nipples are not being used in the nicu anymore because they inhibit the infant's development. based on that info, the o.t. stated that it was better for a infant to be tubed and bolused fed as opposed to the infant given the opportunity to po feed with a premature nipple. she stated she felt only standard term nipples should be offered. if you work or have worked in a nicu, please let me know your thoughts on this.

i am assuming by "preemie" nipple you mean the red fast flow nipple? if that is what you are referring to (and not the smaller pink slow flow nipple) then we did away with them many years ago! we had an rn committee that looked at all the articles and decided that it was not best for our preemie babies. the ot has never liked them, we hated to admit she was right :-) honestly, we have been so happy not using them and our babies are doing great. the ot still has slow-flow and haberman nipples if a baby needs that. does your ot have these also? in reference to being bolused of course we tube feed. if a baby can’t take a feed or finish a feed then we bolus the rest so the baby will get the full amount of calories. i thought everyone did this?

Specializes in Neonatal ICU (Cardiothoracic).

I can't imagine what the point of nippling a 26-27 weeker would be. They should be minimal stim, and their skin shouldn't be subjected to being lifted up for feeds q3h. Not to mention aspiration. I dreadfully miss Similac's blue mini preemie nipples, the ones that had a much narrower and shorter nipple. I used to use those on my IUGR 33-34 weekers until their mouth is big enough to hold a "term" nipple.

i am assuming by "preemie" nipple you mean the red fast flow nipple? if that is what you are referring to (and not the smaller pink slow flow nipple) then we did away with them many years ago! we had an rn committee that looked at all the articles and decided that it was not best for our preemie babies. the ot has never liked them, we hated to admit she was right :-) honestly, we have been so happy not using them and our babies are doing great. the ot still has slow-flow and haberman nipples if a baby needs that. does your ot have these also? in reference to being bolused of course we tube feed. if a baby can’t take a feed or finish a feed then we bolus the rest so the baby will get the full amount of calories. i thought everyone did this?

dear concerned (rn),

i see your join date is the same as mine.wow, what a coincidence!!!!

in response to your question about the preemie nipple, yes i was referring to the red one made by ross. as far as fast flow, these nipples are labled preemie nipple and ring and not fast flow. however they could flow faster than the standard nipple if the infant's oral suck pressure is not decreased, as we all know some preemies are. the red nipples were not made for term babies or preemie babies with a normal suck pressure. we have always bolused feeding, however we have always seen a much happier infant that is able to po feed (with whatever nipple that suits that infant)as opposed to placing a tube down him\her. i do not feed you can standardize any unit. each infant is an individual,and should be treated as such. this involves a little bit of common sense, in which i think our speech therapist is lacking!!!!

i am curious, where is your unit located? i would love to talk to you more,and i want to thank you for concern and comments!!!!

Yes, you are correct, this is my first post. Although I often read the messages, I saw yours was current, and could relate. I suppose that would make it a coincidence, although I don't understand the relevance??? I did not intend to make our process sound easy. It took us over a year, and there were many frustrating times. I completely agree all units and infants are different and you have to advocate for what is best for yours. I work at a hospital in FL and we only have an OT to "vie with" J Sorry your staff is causing such trouble! Good luck!!!

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