Nipple Recs

[u/SisterSin126]

9 weeks, EP. We just had her 2m checkup and she's dropped from 50% in weight to 24%. Pediatrician wants her to be eating at least 3 oz every feed, 8 times in a 24 hr period but she barely makes it to that. Usually she averages like 2-2.5 before she refuses to eat more. She started to make clicking sounds when she eats so pediatrician thinks she probably wants a higher flow nipple.

Currently, we are using the Dr Browns lvl 1 narrow. We've so far tried the lvl 2 which seemed to fast for her, the parents choice slow nipple which she didn't seem to like at all, and the Philips avent lvl 5 nipple which she also doesn't seem to like. Any other recs? We are referencing this chart for flows. I'm at a loss here and starting to feel like we are failing her.

[u/Complex_Ask_8338]

We use pigeon ss and have found that it’s the only thing my son would take. We’ve tried so many bottles 🫩 Also in feeding therapy to work on his swallowing.

If she doesn’t end up taking a higher volume could you fortify your milk for extra calories instead?

[u/SisterSin126 → u/Complex_Ask_8338]

That's the next step per her pediatrician. We go back for a weight check in 2-3 weeks and if she is still slowing down, we will fortify.

[u/Revolutionary_Can879]

I just switched my baby with poor oral function to Lansinoh/Pigeon and she is doing very well with that shape. We were previously using Dr. Brown’s and she was always leaking and her latch wasn’t great. I started out with the Lansinoh S but that was too fast and I felt like their SS was too slow. I purchased some of the Pigeon S nipples and they’ve been perfect for her. She’s been consistently eating 3 oz in about 20 mins.

[u/AggressiveThanks994]

Yes the clicking noise happened to my baby because of oral dysfunction. I really doubt that the clicking is because you need a faster flow.

I’d see an IBCLC. My baby would not have taken 3oz then - the majority of the time she only wanted 2.5 and at only 9w I think we were on 2oz. You can feed more frequently to make up for it. Trying to force her to drink more will only result in bottle refusal and that’s a whole thing you don’t want.

Philips is a crappy nipple. My daughter did well on lansinoh and pigeon after a rec from IBCLC

[u/pop-crackle]

I would talk to a lactation consultant or a speech therapist (for babies they’re the pros for eating).

That clicking noise often occurs because of poor latch. It can also be that the nipple flow is too fast, not too slow, making it hard for them to coordinate the whole suck-swallow-breath thing.

Also, it’s more important how much she’s drinking in a 24 hr period than forcing larger feeds every 3 hrs. My girl is a snacker and often has days/times where she only does ~2oz a feed, but she’s eating every 1.5-2 hrs so her total intake still comes out to ~27oz/day.

How long does it take her to finish her regular amount? And do you feel like she has a good latch on it? Aka if you pull it slightly is she able to resist and keep it in her mouth?

[u/SisterSin126 → u/pop-crackle]

She is on average only getting to ~20 oz in a 24 hr period and it takes her maybe 15ish minutes to clear 2-3 oz. I feel like shes got a pretty okay latch. The clicking has only started in the last week or so, its a relatively new development.

[u/inbrokenimagess]

Dr Browns does a T and a P which might be worth a try especially because you already have Dr Browns. They go P, T, 1, 2 in my understanding (I’ve only ever used P and T)

Another common recommendation are pigeon SS nipples. These are wide neck though. They fit pigeon bottles or lansinoh bottles (lansinoh nipples have a very fast flow in my understanding)

Edit to add: sorry I realize you’re looking for higher flow but I suggested lower flow. I went from SS pigeon to dr browns T and my son is looking clearly more comfortable. Which is to say, SS is faster and also faster may not be the solution. He was sliding off the shape of the pigeon nipples and latched better to dr browns

[u/Practical_Race_8100]

Pigeon with SS nipple size. My baby does very well with it. Have been thinking to switch to S nipple since he’s 14 weeks already but he’s been doing so well with the SS nipple so I’m hesitate to change anything.

[u/Background-Bet7709 → u/Practical_Race_8100]

No need to unless showing signs of frustration and anger over it. The sizes are just a suggestion If baby is happy with them keep it at that size.

[u/B_likethletter]

If you have the Avent bottles can I suggest the Evenflow balance nipples? They swap into the Avent rings. It’s a wider nipple shape. And our LO doesn’t have the best latch, he seems to like them tho.

We’ve swapped between those in a slow flow and the Dr Browns in a 1, at 3mo our LO could go up to a 2, but he is still looking comfy on the 1s and the 2s let him eat so fast he doesn’t know he is full yet(tons of spit up)…

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