By:  Karen Sullen

Even if you're breastfeeding, there are several reasons you may also need to use a bottle at mealtime.  Whether Dad wants to help out with feedings or you're getting ready to return to work, a bottle can help make those necessary transitions easier.  While many may feel that all standard bottles are the same, adding the right type of nipple can make all the difference in the world.  When it comes to knowing your nipples, shape and flow rate are most important.

Shape and Texture
With regards to the shape of the nipple, most gravitate towards nipples that resemble the mother's breast in form and function, especially when they're also breastfeeding.  This helps to avoid nipple confusion in babies who are both breast and bottle-fed.  In general, nipples come in three shapes: the traditional bell or dome shape; a round "orthodontic" design; or a flattened shape.  Choosing a nipple that is textured on the perimeter or has a slightly wide, bulbous shape can feel more realistic to baby.  However, the shape of the nipple for baby's that are only bottle-fed becomes less important because they have nothing with which to compare it.  

Flow rate
Choosing the correct flow rate will depend on the baby's age: newborn or slow flow (for newborn to 3 months), medium flow (for newborn to 12 months), and fast flow (for babies over 3 months). It's best that the nipple allows baby to control the flow rate of the milk.  A nipple should offer some resistance, but not so much that your baby has to struggle to get milk.  More aggressive sucking should produce more flow, and the flow should stop when the baby stops.  Other options include nipples specifically designed for premature babies and variable-flow nipples that allow you to adjust the flow with a turn of the nipple ring.  Tri-cut nipples (sometimes called Y-cut or cross-cut) are also available for thicker foods, such as infant cereal mixed with formula.  However, the American Academy of Pediatrics doesn't recommend giving a baby "food" through a bottle because it can lead to excessive weight gain.
Latex vs. Silicone
There probably wasn't much choice when you were a baby, but nipples have come a long way from the dark-colored yellow nipples that were once the standard.  Nowadays, clear silicone nipples are a better option with many advantages.  Odors and tastes don't transfer to clear silicone nipples, even after many uses, and they don't carry the potential for allergies that latex can. They also create less of a choking hazard on small pieces that might be chewed off, as silicone nipples are also more difficult (but not impossible) for baby to chew holes in.  Unfortunately, latex nipples can crack, creating a choking hazard and a warm, wet place for bacteria to grow.  

Once you've identified which nipple is most appropriate, keep in mind that the final decision will largely depend on your baby's personal preference.  So avoid stocking up on bottles and nipples until you've identified the one that baby likes best.  When you do, boil them for five minutes before use to remove the artificial taste and to sanitize them.