Determinants of milk flow through nipple units: role of hole size and nipple thickness

Article Abstract:

It has been well documented that infants breathe less during bottle feeding; the more premature the baby, the more ventilation is reduced and may even result in stopped breathing or slowed heart rate. A high rate of flow of milk through the nipple of the bottle may contribute to these effects. There are different types of nipple units available. Flow of milk through the nipple can be altered by the nipple's own characteristics, the rigidity of the container, and the sucking strength of the baby. By isolating the other factors, the nipple characteristics were able to be studied, specifically the size of the nipple hole and the thickness of the nipple wall itself. Two different nipple units were tested, the standard unit and the Nuk-type nipple, which is flatter and shaped to accommodate the inside of the mouth. The size of the hole and nipple thickness were determined for each unit. Both air flow through the hole and milk flow caused by mechanical simulated sucking were measured. A great deal of variation was found both within and among the units studied. The milk and air flow measurements were well correlated. Nipple thickness made only a minimal contribution to flow variation. It was concluded that the size of the hole was the main reason for milk flow variability. Design changes may be needed to reduce this variability. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Equipment and supplies, Bottle feeding

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Factors influencing age at referral of children with congenital heart disease

Article Abstract:

Children who have congenital heart disease are treated unequally in the time it takes for medical referral. This depends on insurance, physician, and location. In a study of 544 children with congenital heart lesions, rural children in the neonatal period were referred an average of 5.2 days later than urban children. After the neonatal period, the differences became longer. Among children with managed care, referrals averaged 279 days, while those with commercial insurance averaged 165 days. Pediatricians referred in 136 days while non-pediatricians averaged 222 and rural referrals averaged 213 days against 136 in cities.

Health aspects, Care and treatment, Medical care, Demographic aspects, Congenital heart defects, Congenital heart disease in children, Health maintenance organizations

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