Congratulations to our NICU colleague Deborah Levine-Kotin for her recent publication regarding positive impacts of reusable bottles versus disposable in the NICU. So many takeaways that inform our NICU practice. From the wonderful benefits of partnering with nursing authors to look at and improve practice, to improved LOS with predictable feeding experiences , and improved LOS with reusable bottles… these are all outcomes many of us have noted clinically that now have data to support them.

Haynes, A., et al (2026). Impact of reusable bottle nipples compared to dis posable bottle nipples on infant feeding outcomes in the NICU. Pediatric Nursing, 52(1), 7-12, 51.

From the Abstract: Research has shown that variability of disposable bottle nipples impacts infant feeding experiences. Negative feeding experiences impact time to full feeds and length of stay (LOS). At the time of this study, utilization of reusable bottle nipples from the initiation of oral feeds had not been examined in relation to infant outcomes. This study examined the impact of reusable bottles on time to full feeds, LOS, and feeding stability when compared to disposable bottles among infants born 28 to 35 weeks. Chart reviews were completed on a pre-intervention group of 50 patients and post-intervention group of 50 patients. Data were collected through chart reviews of the primary outcomes: time to full feeds, LOS, and feeding stability score (FSS). The repeating measure of FSS was collected on 25 pre intervention and post-intervention charts. Secondary outcomes included hospital costs and sustainability measures. When adjusted for gestational age, LOS in the post-intervention group was 3.59 days shorter (p = -0.13) than infants in the pre intervention group. Nipple change alone was not an indicator of decreased FSS or decreased LOS. Rather, infants with any bottle brand change during their stay regardless of group went home 2.4 days later (p = -0.06). Change to reusable bottles saved 1130 pounds of plastic waste annually. Findings from this study support the use of reusable bottles from the initiation of oral feeds to decrease LOS.   

• Feeding Stability
  • Score was based on use of Br Brown’s  IDF documentation
  • After a bottle brand change, infants had a 75% higher likelihood of having a decreased Feeding Stability Score. This makes sense given the unique designs and mechanics of each bottle brand
• Length of stay:
  • infants with any bottle brand change (disposable to reusable or one reusable brand to
    another)  during their hospital stay went home 2.42 days later than infants who used the same bottle brand throughout their stay.
  • infants who received a reusable bottle nipple from the initiation of oral feeds had on average
    went home 3.6-days sooner

Catherine’s Key Takeaways:

• For preterm infants in the NICU, consistency and predictability matter when it comes to learning to orally feed

• The impact of nipple flow changes was not explored in this study but is a critical dynamic in supporting safe and successful PO feeding in the NICU and  after discharge. Its potential to alter the swallow-breathe-interface and airway protection is worrisome.

• Data continue to reinforce  the multiple benefits of Dr. Brown’s nipples for neuroprotective  infant-guided feeding for preterm infants.