Our level 3d unit has not used "red" nipples for several years due to the rapid flow and increased risk of aspiration/apnea and bradycardia we see in premature infants. We typically use a "tri-flow" nipple set on "slow" for most premature infants, feed in a side lying position and move to straight yellow or NUK nipple as tolerated then to semi-upright positioning based on infant tolerance as demonstrated by no apnea/brady or desaturations below target range, no mottling with feedings and good suck swallow breathe coordination.
Donna Lynette Lewis RNC, WCC
Clinical Resource Nurse NICU/NN
Saint Francis Children's Hospital
Tulsa, OK