Bottles

There are several bottles and nipples available for children with PRS. Sometimes, it takes a combination of bottles and nipples to arrive with the best solution. Sometimes, the nipples have to be altered to increase the flow of milk. Using a nipple with a cross cut and adjusting the cuts may be beneficial.

Orthodontic nipples, such as Nuk or soft preemie nipples.  Using plastic bottle liners by pushing the air out before you begin feeding and applying pressure while the baby is feeding.

The Mead Johnson Cleft Palate Nurser has a soft, thin-walled nipple that is already cross cut. The long nipple is designed to direct the milk flow past the cleft. The bottle is soft and can easily be squeezed in rhythm with the infant's suck and swallow. This technique overcomes the baby's inability to create the vacuum needed to suck milk from the bottle. The bottle should be gently pulsed, not continually squeezed. Following the infant's own rhythm helps to ensure that he or she does not inhale milk into the lungs, an occurrence called “aspiration.”

The Haberman Feeder has a large, squeezable nipple with a slit rather than a cross cut. Markings around the base of the soft, pliable nipple indicate the position of the slit relative to the infant's mouth. The markings allow the person feeding the baby to control how quickly the milk flows. A disc located inside the base of the nipple acts as a one-way valve to allow milk into the nipple, while reducing the amount of air in the nipple that the baby can swallow. This nipple comes in two sizes--regular and "mini." While the regular nipple is standard length, the mini nipple is shorter, equivalent to a preemie nipple.

Haberman Feeder
Medela
1101 Corporate Dr.
McHenry, IL 60051
815.363.1166
800.435.8316
http://www.medela.com/NewFiles/specialtyfdg.html#haberman
customer.service@medela.com

For replacement Haberman parts:  please note that neither of these places send sterilized equipment because they purchase them in bulk and divide them out so they will need to be sterilized prior to the first use.
http://www.mybreastpump.com
www.selfexpressions.com
 

The Pigeon Bottle comes with a nipple that has a Y-cut (as opposed to an X cross-cut). The nipple is slightly larger and more bulbous than other types of nipples, fitting naturally into the oral cavity. It is firm on top and soft at the bottom to allow for easy tongue compression. An air valve prevents the nipple from collapsing while the baby is sucking. Tightening or loosening the collar on the bottle controls the speed of the flow of milk. The stopper, or back-flow valve, prevents the milk from flowing back into the bottle from the nipple and reduces the amount of air the infant swallows. Although the bottle is not soft, it is pliable.

Pigeon Cleft Palate Nurser
Distributed by Children’s Medical Ventures
South Weymouth, MA
800.345.6443 Hospital Orders
888.766.8443 Parent Orders
http://www.childmed.com/Product_Info/product.cfm?p=2CB0E508-3757-4B8A-88E934A055213CB3

No matter what nipple or feeding system you use, feeding is often easier if the nipple is angled to the side of the mouth so that milk is directed away from the cleft. In this way, the baby can squeeze the nipple between his or her tongue and upper gum. Your health care provider can help you choose the nipple or feeding system that will work best for you and your infant.

Other types of bottles can be found at:
http://www.cleftadvocate.org/feeders.html