[8] Proper cleaning and sterilization of bottles are recommended to avoid bacterial contamination and illness, particularly in areas where water quality and sanitary conditions are not good.A safe baby bottle should not break, should not come apart easily into small or potentially harmful components, should not be made of materials that pose a health risk, and should be easy to clean so as to avoid bacterial contamination and illness.[41][42] Medical experts have suggested reducing exposure to microplastics by not shaking plastic bottles or exposing them to high temperatures.[44] The height-to-width ratio of bottles is high (relative to adult cups) because it is needed to ensure the contents flood the teat when used at normal angles; otherwise the baby will drink air.[8] A 2012 study comparing two types of vented bottles with anti-vacuum features found no differences in infant growth between randomized groups.Infants fed using "Bottle A" were reported to engage in less "fussing", but no difference were found in "crying" or "colic" or in rates of ear infection.[48] Health recommendations for the storage and handling of human milk typically focus on preventing the growth of dangerous bacteria, but some research is also being done on nutrition."[50] Characteristics such as the shape of the nipple and the way it is perforated may impact flow rate and the coordination of sucking, swallowing and breathing during feeding.[51] Bottles may be designed to attach directly to a breast pump for a complete "feeding system" that maximizes the reuse of the components.[citation needed] Sterilization is a standard practice to prevent development of bacteria and resulting illness, that is more effective than sanitization.[55][57] The United States Centers for Disease Control and Prevention, suggests that it may be sufficient to clean bottles with soap and water, in a dishwasher or by hand.[63][64] In 2009 in the United Kingdom, researchers found contamination with Staphylococcus aureus in 4% of the baby bottles that parents reported were ready to fill after cleaning and disinfecting.[63] A study of children admitted to hospital in Rawalpindi, Pakistan, found that 52.1% of the bottles their caregivers considered clean were actually contaminated.[67][68] Research into the preparation of infant formula in South Korea indicates significant levels of contamination can be transmitted through the handling of spoons and other utensils.[102][103] As early as 1500 BCE, Egyptian pottery shows images of women breastfeeding their babies and also using animal horns to feed them.Understanding of both nutrition and sanitation lagged behind the introduction of artificial feeding methods, contributing to extremely high infant mortality rates in the Victorian era.[105][116] As the group American Collectors of Infant Feeders notes, by "the late 1800s a large variety of glass nursing bottles were produced in the United States", and the U.S. Patent Office had issued more than 200 patents for various designs of nursing bottles by the 1940s—designed to lie flat or stand up straight, with openings on their sides or ends, with detachable or permanently attached nipples, etc.[119][120] A bottle with a long Indian rubber tube ending in a teat remained popular until the 1920s because even very young babies could feed independently.[110][104] Allen and Hanbury introduced a new bottle design with a removable valve and teat on the two ends in 1894, and an improved model, the Allenbury, in 1900.[121] Eventually increased understanding of the causes and transmission of disease and improvements in medicine and public health began to reduce infant mortality.[125] Soft nipples of various materials were introduced early in the history of feeding (e.g., leather, cork, sponge, dried cow's teat filled with cloth).Early black Indian rubber "had a very strong pungent smell", and did not survive repeated exposures to hot water.[127] Her patent was one of many attempts to design a bottle to limit swallowing of air during feeding, and reduce gastric upset and spitting up.A plastic bottle with a disposable liner was eventually tested at George Washington University Hospital and marketed by Playtex.[128] Innovations such as the introduction of a working check valve in the nipple (to provide unidirectional flow of the liquid food) appeared as early as 1948 in a patent to J.W.[129] This technology was picked up by others including Owens-Illinois Glass,[130] eventually making its way into Gerber and all modern pressure-balancing bottle designs.[135] The 2014 summary policy statement of the American Academy of Pediatrics (AAP) makes no specific mention of bottle feeding, but makes clear that "[b]reastfeeding and human milk are the normative standards for infant feeding and nutrition", and refers to decisions regarding the supply of infant nutrition as "a public health issue and not only a lifestyle choice… [g]iven the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding".[136][137] The AAP policy recommends breastfeeding exclusively for six months, continuing it with introduction of complementary foods, with an overall duration of "1 year or longer as mutually desired by mother and infant".[137] The transmission of some viral diseases through breastfeeding is reportedly preventable, e.g., by expressing breast milk and subjecting it to Holder pasteurization.[138] In response to public pressure felt from policies de-emphasizing bottle- and formula-feeding, efforts have arisen to support mothers experiencing physiologic or other difficulties in breastfeeding, and sites include individual views that attempt to weaken the scientific case of the AAP policy;[139] a book of the personal experiences and views of one mother committed to bottle/formula feeding, Bottled Up, by Suzanne Barston, has appeared.