UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
4301 West Markham Street - Little Rock, Arkansas 72205
Types of Nipples
Used in the NICU
Enfamil Slow-Flow Nipple (Green Ring):
WHAT IS THE FLOW RATE?
This is the hospital slow-ow nipple, disposable
Slowest ow rate for the disposable nipples
Variable ow rates between each individual nipples because they are not
laser cut
WHO USES IT?
Any infant (TNB, PTNB) could benet from the slower ow rate to assist
with SSB coordination.
WHERE CAN I BUY IT?
not readily available to buy in the community
Enfamil Standard Nipple (Blue Ring):
WHAT IS THE FLOW RATE?
This is the hospital standard or MEDIUM ow rate, disposable
This nipple is a faster ow rate than the Enfamil Slow-Flow nipple (green
ring)
Variable ow rates between each individual nipples because they are not
laser cut
WHO USES IT?
Term newborns without feeding issues
WHERE CAN I BUY IT?
Not readily available to buy in the community
Dr. Brown’s Level 1 Nipple:
WHAT IS THE FLOW RATE?
Considered Dr. Brown’s “slow ow” nipple
Marketed with air vent system to maintain positive pressure to reduce
colic, spit up, burping, and gas
The Level 1 nipple is a comparable ow rate to the Enfamil Slow-Flow
nipple (green ring).
WHO USES IT?
Any infant (TNB, PTNB) could benet from the slower ow rate to assist
with SSB coordination.
WHERE CAN I BUY IT?
It comes standard with most Dr. Brown’s bottles bought in the store.
You can buy it in most major stores.
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
4301 West Markham Street - Little Rock, Arkansas 72205
NUK Slow-Flow Nipple:
WHAT IS THE FLOW RATE?
Orthodontic nipple with a broader base, soft
Despite being a slow ow nipple, it has a fast ow rate.
WHO USES IT?
This nipple is appropriate for infants with a “munching” suck pattern or
very high palatal vaults that affect the lingual palatal seal.
Not recommended for most PTNBs or infants who are breastfeeding.
WHERE CAN I BUY IT?
You can buy it in most major stores.
Dr. Brown’s Preemie Nipple:
WHAT IS THE FLOW RATE?
The Dr. Brown’s Preemie nipple is a slower ow rate than the Dr. Brown’s
Level 1 nipple and the Enfamil Slow-Flow nipple.
WHO USES IT?
This nipple is a good option for premature infants who are having
difculty with a slow-ow nipple.
Babies needing this reduced ow rate are followed by SLP services.
WHERE CAN I BUY IT?
The Preemie nipple is not available in most major stores. You can buy it at
Babies “R” Us and order it online at Amazon.com.
Dr. Brown’s Ultra Preemie Nipple:
WHAT IS THE FLOW RATE?
The Dr. Brown’s Ultra Preemie nipple is 35% slower ow rate than the
Dr. Brown’s Preemie nipple.
Babies needing this reduced ow rate are followed by SLP services for
aspiration risks.
WHO USES IT?
This is an option for infants who appear unsafe from a swallowing
standpoint with all other nipple options.
If a baby needs this nipple, consider caution with po advancement.
WHERE CAN I BUY IT?
This nipple is not available for purchase outside of the hospital.
This is not an appropriate nipple for discharge home.
Nipple Types, continued
(Page 2 of 4)
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
4301 West Markham Street - Little Rock, Arkansas 72205
Nipple Types, continued
(Page 3 of 4)
Dr. Brown’s Level 2 Nipple:
WHAT IS THE FLOW RATE?
Advertised as the “3-6 months” nipple
Faster ow rate than the Level 1 nipple
WHO USES IT?
Rarely used in the NICU with thin liquids
Mostly used with thickened liquids (typically nectar consistency)
WHERE CAN I BUY IT?
You can buy it in most major stores.
Dr. Brown’s Level 3 Nipple:
WHAT IS THE FLOW RATE?
Advertised as the “6-9 months” nipple
Faster ow rate than the Level 2 nipple
WHO USES IT?
Rarely used in the NICU with thin liquids
Mostly used with thickened liquids (typically nectar, stiff nectar, or honey
consistency)
WHERE CAN I BUY IT?
You can buy it in most major stores.
Pigeon Bottle:
WHAT IS THE FLOW RATE?
Specialty cleft bottle
It is a Y-cut nipple that has a thick and thin side with a one way valve
which helps with liquid expression.
Nipples come in small and regular sizes.
It has a faster ow rate to assist with liquid expression.
WHO USES IT?
Infants with cleft lip or cleft palate
Can also be used with infants who have reduced sucking strength/lingual
palatal seal.
WHERE CAN I BUY IT?
Online only for purchase
If patient is followed by ENT, they can get bottles at the ACH Cleft Clinic.
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
4301 West Markham Street - Little Rock, Arkansas 72205
Nipple Types, continued
(Page 4 of 4)
Medela Special Needs Feeder (Haberman Bottle):
WHAT IS THE FLOW RATE?
Specialty cleft bottle
Has a one-way valve to help with liquid expression.
Has 3 different ow rates (slow, medium, fast) depending on placement of
the nipple in infant’s oral cavity.
You have the option to provide assistive squeezing with sucking effort to
assist with liquid expression.
WHO USES IT?
Infants with cleft lip or cleft palate
Good to use with infants who have Pierre Robin sequence.
WHERE CAN I BUY IT?
Online only for purchase
If patient is followed by ENT, they can get bottles at the ACH Cleft Clinic.
Dr. Brown’s Cleft Specialty Bottle:
WHAT IS THE FLOW RATE?
Specialty cleft bottle
Any Dr. Brown’s nipple will t into the bottle.
It has a one way valve to help with liquid expression.
WHO USES IT?
Infants with cleft lip or cleft palate
Can also be used with infants who have reduced sucking strength and
reduced liquid expression.
WHERE CAN I BUY IT?
Online only for purchase
If patient is followed by ENT, they can get bottles at the ACH Cleft Clinic.
Created 3/16