Patent Publication Number: US-10780025-B2

Title: Apparatus and methods for oral administration of fluids and medical instrumentation

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation U.S. application Ser. No. 14/705,633, filed May 6, 2015, which is a continuation U.S. application Ser. No. 14/250,734, filed Apr. 11, 2014, which is a continuation of U.S. application Ser. No. 14/062,736, filed Oct. 24, 2013, which is a continuation-in-part application of International Application No. PCT/US2013/037492 filed Apr. 19, 2013, which claims priority to U.S. Provisional Application 61/636,401 filed Apr. 20, 2012, U.S. Provisional Application 61/659,360 filed Jun. 13, 2012, U.S. Provisional Application 61/709,053 filed Oct. 2, 2012, and U.S. Provisional Application 61/802,141 filed Mar. 15, 2013. Each of the above-identified applications is hereby incorporated herein by reference in its entirety. 
    
    
     BACKGROUND 
     Field of the Invention 
     Embodiments disclosed herein relate to apparatuses, systems, and methods for administering fluids and medical devices. More particularly, the present disclosure describes a pacifier apparatus and related systems and methods for the oral delivery of fluids and medical instrumentation to promote health and well-being. 
     Description of the Related Art 
     Often when a neonate, infant, child, or any infirmed or injured individual is a patient in a hospital, the individual will receive multiple fluids and medications. The individual may also be attached to one or more medical devices and undergo one or more medical procedures during the hospital stay. The entire experience can be stressful and overwhelming. Patients benefit from being soothed and comforted while in the hospital. 
     Many parents and caregivers use pacifiers to relax and soothe their young children and to help them sleep. The most popular pacifier designs are rather simple devices formed of a nipple and a mouth guard. Many young children find comfort in a variety of settings by suckling on such pacifier nipples. Currently, a pacifier in the mouth of a patient must be removed before medications, fluids, or medical instrumentation can be administered orally. 
     SUMMARY 
     Circumcision, venipuncture, and diagnostic examinations are just a few of the painful and traumatic procedures to which newborns and infants are subjected. Several studies have shown that the neurons that convey painful stimuli are well developed in the newborn brain, and systemic stress from a painful stimulus may negatively affect major body systems. Accordingly, in recent years, the medical industry has begun to seek methods and apparatuses for reducing the pain experienced by infants during painful procedures. Studies have shown sucrose administration to be a safe and effective means of reducing procedural pain in the newborn. Other clinical research suggests that non-nutritive sucking in conjunction with sucrose intake provides a synergistic analgesic effect. Accordingly, medical centers are increasingly developing protocols for orally administering a sucrose serum to infants prior to performing painful medical procedures. In many hospitals, these protocols involve dipping a pacifier or a gloved practioner&#39;s finger into a sucrose solution and inserting it into an infant&#39;s mouth. Recently, more advanced pacifiers have been developed for dispensing sucrose, such as those discussed by Crowe et al. U.S. Pat. No. 5,772,685 and Stewart U.S. Pat. No. 8,118,773. However, there are many shortcomings associated with currently available designs. 
     Many existing pacifiers require that the fluid be injected into the device at the site where the procedure takes place. These designs lack an understanding of one of the most valuable and scarce resources in a healthcare facility—time. Previous devices and methods also include complex devices with multiple moving pieces and other advanced features. Such devices tend not to be user friendly, disposable, or well suited for one-time procedural use. Moreover, most current devices are not suitable for neonates who have not yet developed the ability to extract a fluid through sucking, due to prematurity of intraoral musculature, ankyloglossia, or the like. 
     Available devices also neglect the lifecycle of pre-procedural, intra-procedural and post-procedural pain. Studies have shown that the peak effects of sucrose are delayed for two minutes upon administration and the analgesic response to sucrose lasts nearly four minutes. Also, post-procedural symptoms such as tachycardia, increased breathing, and pain can be mitigated through additional ingestion of sucrose after a procedure. Recent studies suggest that for optimal analgesic effect to occur, a controlled dose of an analgesic over a given period of time is superior to larger, uncontrolled quantities of analgesic given in a shorter period of time. Accordingly, a need exists for a device which can adjust for procedural time by expressing a precise and targeted amount of fluid during a short duration procedure, while also extending the expression time to provide post-procedural analgesic effects during a longer procedure. However, such devices are lacking in the market. There is still a gaping need for a fluid dispensing/fluid administration apparatus that requires minimal effort to prepare on the part of a health care practitioner and can also provide an analgesic effect (or other comfort/relief) throughout the length of a procedure and post-procedure. 
     The market also lacks a device which can express, store, and orally administer colostrum using, in part, a fluid administration device specifically tailored for premature infants and other neonates. Colostrum is known to contain antibodies, growth factors, and anti-inflammatory agents important for the development of a child&#39;s immune system. It is important for all infants, even those who have not yet developed the ability to extract a fluid through sucking, to receive their mother&#39;s colostrum soon after birth. 
     Currently available fluid administration devices also fail to sufficiently address the problems that exist in the outpatient, home use, and commercial markets where issues related to currently available devices have recently led to recalls of major fever and pain relieving drugs. A need exists for a fluid administration apparatus configured to expel a precise and targeted dosage of fluid to an infant or other individual. It would be particularly advantageous to have a fluid administration apparatus capable of administering a targeted dosage of a medicament to an infant or patient in a soothing and familiar manner with a controlled flow rate. A need also exists for a fluid administration apparatus that allows infants to ingest a premeasured amount of medication at their own natural rate of suckling. 
     Additionally, the market, especially the hospital market, currently lacks a device that can be used as a soother, and when necessary, can be used as a medical delivery platform as well. It would be advantageous to have a soothing pacifier that can receive multiple medical accessories and devices, such as, for example, for the oral delivery of catheters, imaging scopes, intubation tubes, and/or transitional feeding attachments. 
     As a result of these gaps in the market, a need exists for an improved device capable of addressing one or more of the above-mentioned needs. 
     Disclosed herein are various embodiments of a fluid administration apparatus or pacifier, and related systems and methods, which may fill one or more of the aforementioned needs of the inpatient and outpatient markets. It is conceived that embodiments of the present technology may be used to administer any desired substance, including for example, analgesics, probiotic cultures, vitamins, nutritive solutions, colostrum, breast milk, antibiotics, anti-gas solutions, over-the-counter medicaments, other liquid medicaments, and other fluids. Some embodiments may additionally or alternatively be used as a medical platform used in the oral delivery of medical instrumentation. 
     While various examples disclosed herein are directed to neonates, infants, and/or children, this is merely done to simplify the description. It should be understood that the present embodiments are in no way limited to use within those exemplified populations. All apparatuses, systems, methods, and kits disclosed herein may also be used with geriatric populations and children and/or adults who struggle with oral-muscular activities, such as swallowing solid foods, due to disability or incapacitation. Additionally, embodiments disclosed herein may be utilized in a veterinary setting. 
     Some embodiments of the disclosed apparatus and system: are disposable, limit a receiving individual&#39;s ingestion of air, and/or provide a mechanism for expelling fluid into the mouth of a receiving individual when the individual is unwilling or unable to suck. Some embodiments of the devices, systems, and kits disclosed herein are configured to dispense fluid at any angle regardless of the position of the fluid-receiving individual. Additionally or alternatively, some embodiments provide a measurement of the amount of fluid expelled from the fluid-administrating apparatus. In some embodiments disclosed herein, the apparatus provides a controlled flow rate upon actuation (e.g., squeezing by a caregiver and/or sucking by a fluid-receiving individual) to ensure adequate fluid administration, prevent unnatural flow, and eliminate gag and choking responses. 
     It should be understood that the apparatuses, systems, and methods of the present technology have several features, no single one of which is solely responsible for the desirable attributes described herein. Without limiting the scope, as expressed by the claims that follow, the more prominent features will be briefly disclosed here. After considering this discussion, one will understand how the features of the various embodiments provide several advantages over traditional pacifiers and current fluid administration devices. 
     Several embodiments of the present technology are directed to a pacifier apparatus configured for administering fluid. In one disclosed embodiment, the pacifier apparatus includes, at least, a nipple base and a nipple. The nipple base of some embodiments includes, for example, a proximal face, a distal face, and a passage wall defining a passage extending through the base, and the nipple extends proximally from the proximal face. The nipple of some embodiments includes, for example, a nipple wall having a distal end coupled to the nipple base and a nipple aperture at a proximal tip. The nipple wall defines a cavity configured to hold a fluid, and the nipple of various embodiments is configured to expel the fluid through the nipple aperture in response to the nipple being sucked. 
     The pacifier apparatus of some embodiments also includes a balloon. The balloon of some embodiments has, for example, a body and a distal mouth coupled to the nipple base, and the balloon of some embodiments is configured to transition from at least a substantially undeployed state to a substantially deployed state in response to the nipple being sucked. In the deployed state of various embodiments, the balloon body is configured to extend into the cavity and substantially block the passage of air through the nipple aperture, signal complete medicine intake, and eliminate further fluid flow. In some embodiments of the apparatus, the balloon, in the deployed state, has a size and shape relatively comparable to the size and shape of the nipple. In such embodiments, the balloon is configured to substantially line an inner perimeter of the nipple wall when fully deployed. Deployment of the balloon may facilitate expulsion of fluid from the nipple cavity through the nipple aperture. 
     Some embodiments of the apparatus further include a rigid member positioned at least partially within the passage of the nipple base. The rigid member of some embodiments is configured to provide a mechanism for securing the distal mouth of the balloon relative to the nipple base, and in some embodiments, the distal mouth of the balloon is affixed around or within the rigid member. 
     The pacifier apparatus of some embodiments further includes a pump. In various embodiments, the pump may be configured as an alternate mechanism for expelling solution from the device and/or for transitioning the balloon toward the deployed state and for thereby expelling fluid from the nipple aperture. In some embodiments, the pump is shaped, for example, as a syringe having a syringe body and a plunger. In some embodiments, the rigid member extends from the pump and is configured for positioning within the passage of the nipple base. The rigid member may be integrally coupled to the pump, for example. In some such embodiments, the apparatus further includes, for example, a locking ring positioned around the distal mouth of the balloon such that the distal mouth and the locking ring are positioned between the rigid member and the passage wall, securely coupling the distal mouth of the balloon, the locking ring, the rigid member, and the nipple base together. In some of these embodiments, at least a portion of the locking ring is affixed within the nipple base. The rigid member of some embodiments includes a coupling element, for example, a ridge, a perforation, an indentation, or threading for coupling the rigid member to the locking ring. In one embodiment, the balloon mouth is positioned around a proximal portion of the rigid member, and a distal portion of the rigid member, which includes the coupling element, is configured to couple directly to the locking ring. In another embodiment, the rigid member is configured to couple indirectly to the locking ring, with the distal mouth of the balloon positioned between the coupling element of the rigid member and the locking ring. 
     In some embodiments, the apparatus further includes a pump base fixedly connected to a proximal end of the pump. In some such embodiments, the rigid member extends proximally from the pump base and is configured for positioning within the passage of the nipple base. In such embodiments, at least a proximal portion of the rigid member is configured to securely engage the distal mouth of the balloon and be positioned within the passage of the nipple base, and a distal portion of the rigid member is configured to securely engage the pump base. In some such embodiments, the rigid member may be integrally connected with the pump base. 
     In other embodiments, the rigid member extends proximally from a rigid plate and is positioned within the passage of the nipple base. In some embodiments, the rigid plate includes a distally extending handle. In the alternative or in addition, the rigid plate of some embodiments includes a second rigid member extending distally from the rigid plate. In some such embodiments, the second rigid member is configured to engage with a pump. In others, the second rigid member is configured to engage with a pump base. In some embodiments, a pump in the form of a syringe extends from, and removably couples to, the rigid plate. In various embodiments, the apparatus additionally or alternatively includes one or more anchors extending from the rigid plate and/or from the pump or pump base, which are configured to extend through a plurality of holes in the nipple base to fixedly secure the rigid plate and/or the pump to the nipple base. 
     In another disclosed embodiment, an apparatus for administering fluid includes a pacifier apparatus having an integral, unitary body. In some embodiments, the unitary pacifier includes, for example, a nipple base having a distal face and a proximal face, a nipple extending proximally outward from the proximal face, and optionally, a handle extending distally outward from the distal face. The nipple of some embodiments includes, for example, a nipple wall configured for sucking, and the nipple wall and a portion of the proximal face define a substantially closed cavity configured to hold a fluid. The pacifier of several embodiments also includes, for example, a nipple aperture at a proximal tip of the nipple and a distal opening to the cavity in the nipple base. 
     In other embodiments, the unitary pacifier apparatus includes, for example, a nipple base having a distal face, a proximal face, and a passage wall defining a passage extending through the nipple base, a nipple extending proximally outward from the proximal face, and a depressible pump extending distally outward from the distal face. The nipple of various embodiments includes, for example, a nipple wall configured for sucking, and the depressible pump includes a compressible wall configured for squeezing or applying force. The nipple wall and compressible wall each connect with the passage wall to define a cavity configured to hold a fluid. The pacifier of some embodiments further includes, for example, a nipple aperture at a proximal tip of the nipple and a distal opening to the cavity through the depressible pump. In some embodiments, the distal opening to the cavity includes, for example, one or more of a valve, a hole, a slit, and a frangible seal. In some of the abovementioned embodiments, the pacifier apparatus having a unitary body is formed of a material that includes one or more of silicone, plastic, rubber, and other polymers. 
     In another disclosed embodiment, a pacifier apparatus configured for administering fluid includes, for example: a nipple base having a proximal face, a distal face, and a passage extending through the nipple base; and a nipple extending proximally from the proximal face and having a nipple wall, which defines a cavity, is configured for sucking, and has a nipple aperture at or near a proximal tip. In some embodiments, the nipple aperture is disposed along a bulbous proximal end of the nipple offset from the proximal tip; in some such embodiments, the distal opening to the cavity is axially aligned with the off-center nipple aperture. The apparatus of this embodiment can be configured, for example, to securely couple to a cartridge such that at least a portion of the cartridge is positioned within the passage and the cavity. In some embodiments, the apparatus includes a receiving tube disposed within the cavity and the passage, wherein the receiving tube is sized and configured to securely couple to a proximal portion of a cartridge. In some embodiments, the apparatus may include a plurality of receiving tubes disposed within the cavity and the passage. In some embodiments, these one or more receiving tubes run along a length of the nipple wall. 
     In another disclosed embodiment, a nipple apparatus, such as a pacifier, is configured for the oral administration of healthcare products. Healthcare products is a broad term encompassing any product, composition, or device used in the promotion of health or treatment of disease, including, for example, medicines, nutritional supplements, vitamins, nutraceuticals, breast milk, analgesics, fluids, colostrum, and any healthcare accessory, such as, for example, imaging scopes, intubation tubes, and enteral feeding syringes. In some embodiments, the nipple apparatus includes: a nipple base having a proximal face, a distal face, and a passage extending through the nipple base; a nipple extending proximally from the proximal face, the nipple defined by a contoured nipple wall having a nipple aperture disposed on a proximal end of the nipple wall; a receiving tube extending through the nipple and at least a portion of the passage, the receiving tube having a proximal portion which terminates at the nipple aperture; an attachment mechanism disposed in or on the receiving tube for attaching the receiving tube to a healthcare accessory; and an occlusion mechanism coupled to the receiving tube for selectively occluding the receiving tube. The occlusion mechanism may be any suitable structure which non-permanently occludes the flow of air through the receiving tube. Such a structure may limit the ingestion of air by a user. In some embodiments, the occlusion mechanism includes one or more valves, which selectively occlude the receiving tube by remaining closed and occluding the flow of air through the receiving tube until acted on by a force, such as, for example, the insertion of a cartridge into the receiving tube or the expulsion of fluid from the cartridge. In other embodiments, the occlusion mechanism includes one or more plugs. Such plugs are removably coupled to the receiving tube, and can be inserted into, or removed from, a distal end of the receiving tube to selectively control occlusion of air through the receiving tube. In other embodiments, the occlusion mechanism includes one or more healthcare accessories, which when coupled to, and disposed at least partially within, the receiving tube, occlude the flow of air through the receiving tube. In some embodiments, the attachment mechanism includes threading, snap fitting, slip fitting, friction fitting, or other coupling features to couple the receiving tube to a healthcare accessory, such as, for example, a cartridge. 
     The cartridge to which the apparatus may be configured to couple includes, for example, a reservoir configured to hold a fluid and a cartridge aperture at a proximal tip or end of the cartridge. In some embodiments, the cartridge also includes, for example, a pump, a repeatably deformable wall, or other actuator for causing the fluid to be expelled from the reservoir. When such a cartridge is properly coupled, the apparatus is configured to expel a fluid from the reservoir through the cartridge aperture and out of the apparatus through the nipple aperture at least in response to the pump being squeezed. Additionally or alternatively, in some embodiments, the cartridge is configured to expel a fluid from the reservoir through the cartridge aperture and out the apparatus through the nipple aperture at least in response to experiencing negative pressure from an infant&#39;s suck. 
     An embodiment of a system for dispensing fluid is also disclosed. In one embodiment, the system includes, for example, a cartridge containing a predetermined volume of a predetermined fluid. The cartridge includes a reservoir configured to hold a fluid and a cartridge aperture at a proximal tip of the cartridge. The cartridge may also include a pump or other actuating features on a distal portion of the cartridge. As used herein throughout the specification and claims, the term “cartridge” is used to describe any ampoule, vial, syringe, or other container configured to hold and expel a quantity of liquid. In some embodiments, the cartridge is hermetically sealed. The seal may be wholly or partially removable. In some such embodiments, both the cartridge and the seal are sized so as not to pose a choking hazard to young children. In some embodiments, such a cartridge is manufactured using a blow fill seal, injection molding, or other process. In one embodiment, the reservoir may be in the form of a syringe body and the pump may be in the form of a plunger. The cartridge of various embodiments is configured to securely couple to the apparatus described in the previous paragraph or elsewhere herein. Such a cartridge may also be used independently to expel fluid into the mouth of an infant or other individual. 
     In some embodiments, the system is further configured for a single use; in some embodiments, the system includes at least one disposable cartridge and a reusable pacifier apparatus having the characteristics described in the previous paragraph or elsewhere herein. In some embodiments, the cartridge is prefilled with a predetermined volume of a liquid. A kit is also disclosed, which includes a plurality of the cartridges described above. In some embodiments, the kit also includes a pacifier apparatus, such as the ones described in the previous paragraph or elsewhere herein, which can be configured to couple to each of the plurality of cartridges individually and interchangeably. 
     In some embodiments of the apparatuses disclosed herein, the apparatus is configured to deliver a metered quantity of fluid. Some embodiments may be configured to expel fluid from the cavity through the nipple aperture at a desired, predetermined, and/or constant rate. For example, the apparatus of some embodiments is configured to expel fluid at an average rate of 0.0001 mL/s, the apparatus of other embodiments is configured to expel fluid at an average rate of 0.01 mL/s, and the apparatus of other embodiments is configured to expel fluid at an average desired rate therebetween, when sucked by a neonate and/or when the pump is squeezed. Additionally, in many but not all embodiments, the apparatus is disposable and/or adapted for one-time use. 
     The nipple base of various embodiments may be overmolded and the proximal face and the distal face may be curved proximally inward so as to be adapted to fit the curvature of a face. In some embodiments, a center height of the proximal face is shorter than an edge height of the proximal face, and a center height of the distal face is shorter than an edge height of the distal face. With such a configuration, the nipple base has a shape adapted to provide space between the nipple base and a child&#39;s nose when the nipple is positioned within a child&#39;s mouth. In some embodiments, the nipple base further includes a plurality of through-holes configured to allow the passage of air between the distal face and the proximal face. In some embodiments, these through-holes securely but reversibly retain a plug disposed on a strap, and the strap is fixedly connected to the nipple base. The strap of such embodiments is flexible so as to allow for movement of the plug between a through-hole and a distal opening of a receiving tube. 
     In various embodiments, the nipple aperture is in the form of a slit or a hole. In some embodiments, the nipple aperture is positioned on the proximal tip of the nipple; in other embodiments, the nipple aperture is positioned elsewhere on the proximal end of the nipple, for example, on the bulbous portion of the nipple, offset from the proximal tip. Such an offset may mitigate choking of fluid and gag reflex. In some embodiments, the distal opening to the cavity is in the form of a slit, hole, valve, or frangible seal. 
     Additionally, systems for administering fluid are disclosed herein. In one embodiment, the system includes: a pacifier apparatus configured for administering fluid, such as the apparatuses described herein; a fluid stored within the cavity, wherein the fluid has a known volume; and a sterile packaging unit surrounding the apparatus. In one particular embodiment, the fluid includes 2 mL of sucrose solution. In other embodiments, different volumes and/or different fluids are used. In some embodiments, the fluid includes one or more of a probiotic formula, a vitamin formula, a nutritive formula, breast milk, colostrum, sweetened water or other fluid, an anti-gas fluid (e.g., simethicone (Mylicon®)), or a liquid medication. In another embodiment of the system, the system includes a pacifier apparatus configured for administering fluid as disclosed herein, a liquid-filled gel capsule positioned within the cavity, and a sterile packaging unit surrounding the apparatus. In such an embodiment, a coating of the liquid-filled gel capsule may be configured to dissolve when subjected to a known environmental trigger, such as, for example, heat sterilization, to release fluid into the cavity. In an additional embodiment, the fluid or liquid-filled gel capsule is replaced with a powder stored within the cavity, wherein the powder has a known mass and is configured to dissolve in water. In some embodiments, the powder includes a lyophilized solution. The entire system of some embodiments is configured for one-time use. 
     In various embodiments of the system, the sterile packaging unit may include, for example, a shell having a distal shell member, a proximal shell member, and an attachment element configured to detachably connect the distal shell member and the proximal shell member. Moreover, the shell of some embodiments has an inner surface, an outer surface, and a plurality of anchor arms extending from the inner surface into an interior of the shell. The plurality of anchor arms are configured to secure the apparatus in a stable position inside the shell, for example, by engaging with a plurality of through-holes located in the nipple base. In some embodiments, the attachment element includes a pull seal configured to wrap substantially around a circumference of the shell and a pull-tab affixed to an end of the pull seal. The pull seal is configured to fixedly couple the distal shell member to the proximal shell member until the pull-tab is pulled and the pull seal is removed. The pull seal of some embodiments is attached to a proximal end of the distal shell member and a distal end of the proximal shell member via a perforated connection. The sterile packaging unit may additionally include a double-sided adhesive pad positioned on the inner surface, which is configured to contact the nipple aperture and seal it closed while positioned in the packaging unit. In the alternative, the sterile packaging unit may include, for example, a stub anchor extending from the inner surface into an interior of the shell, which is configured for insertion into the nipple aperture to prevent fluid from leaking. 
     In some embodiments, one or more of the systems and/or components, as described herein, are packaged together to form a kit. In one embodiment, the kit includes a plurality of systems having a plurality of age-specific nipple sizes. In some such embodiments, the nipples within the kit each have an age-specific nipple aperture size. The nipples of the apparatuses within the kit are selected such that the sizes are tailored to cover a spectrum of age groups. The kits of some embodiments further include an outer packaging container. In other embodiments, the kits may include, for example, an apparatus as described herein and one or more medicaments that can be used with the apparatuses, or an apparatus and a cartridge that is configured to be inserted in and used with the apparatus. Some embodiments described in more detail herein relate to the cartridges of medicaments or fluids themselves. 
     Another system for administering fluid is disclosed which includes a pacifier apparatus, such as the apparatuses described above, a breast pump, and a mechanism to, or means of, connecting the breast pump directly or indirectly to at least a portion of the pacifier apparatus. In some embodiments, the breast pump can be coupled directly or indirectly to the nipple of the pacifier apparatus such that breast milk or colostrum can be pumped through the nipple aperture and into the nipple cavity. In other embodiments, the breast pump can be coupled directly or indirectly to the nipple base, one or more receiving tubes disposed within the nipple, and/or the pump of the pacifier apparatus, such that milk or colostrum can be pumped through an opening in the nipple base or an opening in the pump of the pacifier apparatus. In still other embodiments, the breast pump can be coupled directly or indirectly to a cartridge configured for insertion into a pacifier apparatus. In various embodiments, the mechanism to, or manner of, connecting the breast pump to at least a portion of the pacifier apparatus includes, for example, tubing, piping, a valve, funnel, blunt tip needle, or other conduit for directing the flow of fluids. It should be understood that in some embodiments, the fluid can be extracted from the mother by the breast pump and then transferred to a device or apparatus as described herein via any suitable method. For example, the fluid in the breast pump can be transferred by pouring, via a syringe, via syringe and needle, via a pump, via tubing and gravity, etc. 
     Some embodiments relate to methods of manufacturing a pacifier apparatus configured for administering fluid. In one embodiment, the method includes, for example, positioning a distal mouth of a balloon around at least a proximal portion of a rigid member such that an air passage exists between a body of the balloon and a hole located on a distal portion of the rigid member or on a pump coupled to the distal portion of the rigid member. The method of some embodiments also includes, for example, permanently affixing the distal mouth of the balloon to at least the proximal portion of the rigid member, and vacating air from the air passage to retract the balloon into an undeployed state. Additionally, the method of some embodiments includes forming a unitary pacifier body, wherein the pacifier body includes a nipple base and a nipple. The nipple base has, for example, a proximal face, a distal face, and a passage extending through the nipple base. The nipple extends proximally outward from the proximal face and includes, for example, a nipple wall, which defines a cavity. In some embodiments, the method further includes securely affixing the balloon mouth and at least the proximal portion of the rigid member to the passage wall, forming a nipple aperture through a proximal tip of the nipple wall, vacating air from the cavity, and filling the cavity with a predetermined volume of fluid. The method may additionally include sealing the nipple aperture temporarily so as to prevent fluid from spilling from the cavity. 
     In some embodiments, forming a nipple aperture includes, for example, making a slit in or near the proximal tip of the nipple wall. In other embodiments, forming a nipple aperture includes, for example, puncturing a hole in or near the proximal tip of the nipple wall. In some embodiments, filling the cavity with a desired volume of fluid includes, for example, injecting the known volume of fluid into the cavity through the nipple aperture. In other embodiments, filling the cavity with a known volume of fluid includes, for example, squeezing the pump, inserting the nipple aperture into a fluid, releasing the pump, and removing the nipple aperture from the fluid when a desired quantity of the fluid has entered the cavity. Vacating air from the cavity includes, for example, vacuuming air from the cavity through the nipple aperture. In other embodiments, vacating air from the cavity includes, for example, expelling air from the nipple aperture by forcing air into the air passage so as to transition the balloon into a fully deployed state. In some embodiments of the method, the step of vacating air from the cavity by forcing air into the air passage may be performed before the step of vacating air from the air passage to retract the balloon into an undeployed state, for example. In other embodiments, the steps may be performed in any desired and/or logical order. In some embodiments, permanently affixing the balloon mouth to at least the proximal portion of the rigid member includes, for example, applying an adhesive between the balloon mouth and the rigid member. In other embodiments, the step includes, for example, fusing the balloon mouth to the rigid member using ultrasonic welding. In still other embodiments of the method, the step includes, for example, fixating an outer locking ring around the balloon mouth after it has been positioned around at least the proximal portion of the rigid member. 
     In an additional embodiment for a method of manufacture, the method includes, for example: molding a unitary pacifier body comprising (1) a nipple base comprising a proximal face, a distal face, and a passage wall defining a passage extending through the nipple base, and (2) a nipple extending proximally outward from the proximal face and having a nipple wall which defines a cavity; forming a nipple aperture through the nipple wall in or near the proximal tip; inserting a balloon through the passage and into the cavity with the balloon in a deployed state; inserting a proximal end of a rigid member into a distal mouth of the balloon such that the rigid member is fixedly coupled directly or indirectly to the passage wall upon insertion; and filling the cavity with a known volume of fluid. In some embodiments, the rigid member is tapered to facilitate insertion into the distal mouth of the balloon. 
     In an additional embodiment of a method of manufacturing a pacifier apparatus, the method includes, for example: molding a unitary nipple assembly comprising (1) a nipple base comprising a proximal face, a distal face, and a passage wall defining a passage extending through the nipple base, and (2) a nipple extending proximally outward from the proximal face and having a nipple wall which defines a cavity; forming a nipple aperture through a proximal tip of the nipple wall; inserting a receiving tube into the cavity and/or molding the nipple so that the cavity is configured to form a receiving tube, wherein the receiving tube is sized and shaped to securely receive a proximal portion of a fluid-filled cartridge. The receiving tube of some embodiments may have various non-uniform diameters along the length of the receiving tube to control the rate of fluid flow by creating high and low pressure channels. In some embodiments, the method may include inserting or forming a plurality of receiving tubes within the nipple of the pacifier. In other embodiments, the method may include molding a valve into the receiving tube to occlude air ingestion until acted upon by a force. In some embodiments, the method also includes molding or attaching a strap with a plug to a nipple base. In one embodiment of using such an apparatus, the method includes removing a seal from the cartridge aperture of the cartridge, inserting a proximal portion of the cartridge into the receiving tube of a nipple assembly, inserting a nipple of the nipple assembly into the mouth of an individual, and actuating the cartridge by deforming a distal portion of the cartridge such that a liquid flows from a reservoir of the cartridge, through the cartridge aperture, through the nipple aperture, and into the mouth of the individual. In some embodiments, a plug can be placed into a through-hole of the nipple base so that the plug is out of the way when the cartridge is coupled to the receiving tube, and the plug can be positioned within a distal end of the receiving tube once the cartridge has been removed. In some embodiments, positioning the plug within the distal end of the receiving tube limits the individual&#39;s ingestion of air as they suck on the nipple of the nipple assembly. 
     A method of manufacturing an age-specific pacifier apparatus configured to administer fluids is also disclosed. In some embodiments, the method includes: determining an average number of sucks performed in a defined length of time by patients of a pre-defined age group; determining a desired length of fluid administration; determining a desired volume of fluid to be administered; calculating an optimum flow rate by dividing the desired volume by the desired length of fluid administration and performing a unit conversion step if necessary; calculating an optimum volume of fluid expelled per suck by dividing the optimum flow rate by the average number of sucks performed in a defined length of time and performing a unit conversion step if necessary; selecting a desired nipple wall thickness, a desired nipple wall density, a desired cavity volume, a desired nipple aperture size, and a desired size of a distal cavity opening, which are together configured to achieve a desired average pressure change within the nipple during a suck and thereby achieve the optimum volume of fluid expelled per suck; molding a pacifier apparatus comprising a base and nipple from a polymeric material, wherein the nipple is molded to have the desired nipple wall thickness and the desired nipple wall density, and wherein the cavity is sized to hold the desired volume of fluid; and puncturing a proximal tip of the nipple to create a nipple aperture having the desired nipple aperture size and a distal end of the pacifier apparatus to create a distal cavity opening having the desired distal cavity opening size. Some embodiments of the method further include filling the cavity with the desired volume of fluid to be administered. The fluid may be filled through the nipple aperture or the distal cavity opening. In other embodiments, the size, shape, strength, and/or position of a receiving tube and/or nipple aperture are selected to achieve a desired angle of fluid expulsion or a desired rate of fluid expulsion when a given negative pressure is applied to the nipple. 
     A method of providing comfort to a child is also described. In various embodiments of the method, the child may be positioned at any angle. The method includes, for example, providing a pacifier apparatus as described herein to a child that is positioned at any angle, wherein the apparatus includes, at least, a pump or actuatable cartridge, a nipple, and a nipple aperture. A fluid is stored within a nipple cavity or a cartridge reservoir. The apparatus of some embodiments also includes a balloon. The method further includes inserting the apparatus into the child&#39;s mouth for sucking, wherein sucking and/or actuating the pump or cartridge causes at least a portion of the fluid to flow from the cavity or reservoir through the nipple aperture and into the mouth. In some embodiments, sucking causes the balloon to gradually transition from an at least partially or substantially undeployed state to a substantially deployed state in which the balloon is positioned in the cavity and forms the general shape of the nipple upon deployment. Additionally, if the child does not suck on the nipple or does not suck forcefully enough, for example, to transition the balloon into the deployed state, the method may include actuating the pump or cartridge to expel fluid from the cavity or reservoir into the child&#39;s mouth. In some embodiments, actuating the pump transitions the balloon into the deployed state, which thereby expels the fluid from the cavity. 
     In an additional embodiment, the method of providing comfort to a child includes providing a pacifier apparatus filled with solution, wherein the apparatus is structured in accordance with any of the embodiments disclosed herein, positioning the apparatus into the mouth of a child so that the child can suck on the apparatus and thereby cause the solution to flow from the apparatus, and if necessary and/or desired, manipulating a pump on the device in order to expel the solution into the mouth of the child if the child does not suck on the device or if the sucking of the child is insufficient to cause a desired amount of solution to flow from the apparatus. In some embodiments, the pump used within the method is, for example, a depressible pump. various embodiments, the comfort provided to the child can be one or more of soothing the child and providing a medicament to the child, for example. In some embodiments, the solution includes, for example, one or more of a sweetened solution, a medicament, water, baby formula, breast milk, colostrum, or any other fluid as described herein or otherwise desired. In accordance with various embodiments of the method, the child may be positioned so as to be at an angle of between about 0 degrees and 180 degrees relative to horizontal. Embodiments are conceived in which the child receives the apparatus while undergoing a medical procedure or examination or when otherwise agitated or upset. The methods can include providing comfort or treatment of a child or patient suffering from or going through an illness, discomfort, or a medical treatment or procedure. For example, the discomfort may be caused by gas, an upset stomach, an injury, or any other cause. The medical treatment or procedure can be one or more of circumcision, receiving a shot, a blood prick or puncture, a diagnostic examination, etc. The illness can be a fever, a cold, a flu, etc. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above-mentioned features, as well as other features, aspects, and advantages of the present technology will now be described in connection with various embodiments of the invention, in reference to the accompanying drawings. The illustrated embodiments, however, are merely examples and are not intended to limit the invention. 
         FIG. 1A  depicts an exploded side view of one embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 1B  depicts a perspective view of the embodiment illustrated in  FIG. 1A . 
         FIG. 1C  depicts a distal view of the embodiment illustrated in  FIG. 1A . 
         FIG. 1D  depicts a cross-sectional view of the embodiment illustrated in  FIG. 1A . The selected viewing angle of the cross-section is identified in  FIG. 1C . 
         FIG. 2A  depicts an exploded side view of a second embodiment of a pacifier apparatus configured for the oral administration of fluids. The exploded view includes depictions of a rigid member assembly, a balloon, and a nipple assembly. 
         FIG. 2B  depicts a distal view of the embodiment illustrated in  FIG. 2A . 
         FIG. 2C  depicts a cross-sectional view of the embodiment illustrated in  FIG. 2A . The selected viewing angle of the cross-section is identified in  FIG. 2B . 
         FIG. 2D  depicts a distal view of one embodiment of a rigid member assembly with a balloon affixed to the rigid member assembly. 
         FIG. 2E  depicts a cross-section of the rigid member assembly and the balloon illustrated in  FIG. 2D . 
         FIG. 3A  depicts a perspective view of an embodiment of a pacifier apparatus configured for the oral administration of fluids, wherein the apparatus includes a pump. 
         FIG. 3B  depicts a side view of another embodiment of a pacifier apparatus configured for the oral administration of fluids, wherein the apparatus includes a pump in the form of a syringe. 
         FIG. 4A  depicts a perspective view of another embodiment of a pacifier apparatus configured for the oral administration of fluids and having a pump. 
         FIG. 4B  depicts a distal view of the embodiment illustrated in  FIG. 4A . 
         FIG. 4C  depicts a cross-sectional view of the embodiment illustrated in  FIG. 4A  with a balloon in an undeployed state. The selected viewing angle of the cross-section is identified in  FIG. 4B . 
         FIG. 4D  depicts a cross-sectional view of the embodiment illustrated in  FIG. 4A  with a balloon in a semi-deployed state. The selected viewing angle of the cross-section is identified in  FIG. 4B . 
         FIG. 4E  depicts a cross-sectional view of the embodiment illustrated in  FIG. 4A  with a balloon in a fully deployed state. The selected viewing angle of the cross-section is identified in  FIG. 4B . 
         FIG. 5A  depicts an exploded side view of another embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 5B  depicts a perspective view of the embodiment illustrated in  FIG. 5A . 
         FIG. 5C  depicts a distal view of the embodiment illustrated in  FIG. 5A . 
         FIG. 5D  depicts a cross-sectional view of the embodiment illustrated in  FIG. 5A . The selected viewing angle of the cross-section is identified in  FIG. 5C . 
         FIG. 6A  depicts an exploded side view of another embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 6B  depicts a distal view of the embodiment illustrated in  FIG. 6A . 
         FIG. 6C  depicts a cross-sectional view of the embodiment illustrated in  FIG. 6A . The selected viewing angle of the cross-section is identified in  FIG. 6B . 
         FIG. 7A  depicts an exploded side view of another embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 7B  depicts a distal view of the embodiment illustrated in  FIG. 7A . 
         FIG. 7C  depicts a cross-sectional view of the embodiment illustrated in  FIG. 7A . The selected viewing angle of the cross-section is identified in  FIG. 7B . 
         FIG. 8A  depicts an exploded side view of another embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 8B  depicts a perspective view of the embodiment illustrated in  FIG. 8A . 
         FIG. 8C  depicts a distal view of the embodiment illustrated in  FIG. 8A . 
         FIG. 8D  depicts a cross-sectional view of the embodiment illustrated in  FIG. 8A . The selected viewing angle of the cross-section is identified in  FIG. 8C . 
         FIG. 9A  depicts an exploded side view of another embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 9B  depicts a distal view of the embodiment illustrated in  FIG. 9A . 
         FIG. 9C  depicts a cross-sectional view of the embodiment illustrated in  FIG. 9A . The selected viewing angle of the cross-section is identified in  FIG. 9B . 
         FIG. 10A  depicts a perspective view of another embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 10B  depicts a distal view of the embodiment illustrated in  FIG. 10A . 
         FIG. 10C  depicts a cross-sectional view of the embodiment illustrated in  FIG. 10A . The selected viewing angle of the cross-section is identified in  FIG. 10B . 
         FIG. 11A  depicts a perspective view of another embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 11B  depicts a distal view of the embodiment illustrated in  FIG. 11A . 
         FIG. 11C  depicts a cross-sectional view of the embodiment illustrated in  FIG. 11A . The selected viewing angle of the cross-section is identified in  FIG. 11B . 
         FIG. 12A  depicts an exploded side view of an embodiment of a pacifier system configured for the oral administration of fluids. 
         FIG. 12B  depicts a perspective view of the embodiment illustrated in  FIG. 12A . 
         FIG. 12C  depicts a distal view of the embodiment illustrated in  FIG. 12A . 
         FIG. 12D  depicts a cross-sectional view of the embodiment illustrated in  FIG. 12A . The selected viewing angle of the cross-section is identified in  FIG. 12C . 
         FIG. 13A  depicts a perspective view of one embodiment of a pacifier system that includes a nipple assembly and a cartridge. 
         FIG. 13B  depicts a bottom/distal view of the embodiment shown in  FIG. 13A . 
         FIG. 13C  depicts a cross-sectional view of the embodiment of  FIG. 13A . The selected viewing angle of the cross-section is identified in  FIG. 13B . 
         FIG. 14A  depicts a perspective view of the nipple assembly embodiment included in  FIG. 13A . 
         FIG. 14B  depicts a top/proximal view of the nipple assembly embodiment of  FIG. 14A . 
         FIG. 14C  depicts a bottom/distal view of the nipple assembly embodiment of  FIG. 14A . 
         FIG. 14D  depicts a cross-sectional view of the nipple assembly embodiment of  FIG. 14A . The selected viewing angle of the cross-section is identified in  FIG. 14C . 
         FIG. 15A  depicts a perspective view of another embodiment of a nipple assembly. 
         FIG. 15B  depicts a top/proximal view of the nipple assembly embodiment of  FIG. 15A . 
         FIG. 15C  depicts a bottom/distal view of the nipple assembly embodiment of  FIG. 15A . 
         FIG. 15D  depicts a cross-sectional view of the nipple assembly embodiment of  FIG. 15A . The selected viewing angle of the cross-section is identified in  FIG. 15C . 
         FIG. 16A  depicts a front view of the cartridge embodiment included in  FIG. 13A . 
         FIG. 16B  depicts a side view of the cartridge embodiment of  FIG. 16A . 
         FIG. 16C  depicts a perspective view of the cartridge embodiment of  FIG. 16A . 
         FIG. 16D  depicts a perspective view of the cartridge embodiment of  FIG. 16A  with a seal removed. 
         FIG. 16E  depicts a side view of the cartridge embodiment of  FIG. 16A  with a seal removed. 
         FIG. 16F  depicts a front view of the cartridge embodiment of  FIG. 16A  with a seal removed. 
         FIG. 17A  depicts a perspective view of another embodiment of a nipple assembly configured to receive a cartridge. 
         FIG. 17B  depicts a top/proximal view of the nipple assembly embodiment of  FIG. 17A . 
         FIG. 17C  depicts a bottom/distal view of the nipple assembly embodiment of  FIG. 17A . 
         FIG. 17D  depicts a cross-sectional view of the nipple assembly embodiment of  FIG. 17A . The selected viewing angle of the cross-section is identified in  FIG. 17C . 
         FIG. 17E  depicts another perspective view of the nipple assembly embodiment of  FIG. 17A . 
         FIG. 18  is a perspective view of another embodiment of a nipple assembly configured to receive a cartridge. 
         FIG. 19A  depicts a perspective view of one embodiment of a sterile packaging unit for any of the apparatuses disclosed herein. 
         FIG. 19B  depicts an exploded view of one embodiment of a system, which includes an apparatus configured for the oral administration of fluids and a sterile packaging unit. 
         FIG. 19C  depicts a perspective view of one embodiment of a proximal portion of a sterile packaging unit. 
         FIG. 19D  depicts a distal view of one embodiment of a sterile packaging unit. 
         FIG. 19E  depicts a cross-sectional view of the sterile packaging unit embodiment illustrated in  FIG. 13D . 
         FIG. 20A  depicts a perspective view of an embodiment of a bulk shipping configuration for the sterile packaging units disclosed herein. 
         FIG. 20B  depicts a distal view of the bulk shipping configuration embodiment illustrated in  FIG. 14A . 
         FIG. 20C  depicts a cross-sectional view of the bulk shipping configuration embodiment illustrated in  FIG. 14B . 
         FIG. 21  depicts a perspective view of an embodiment of a method of assembling one embodiment of a pacifier apparatus configured for the oral administration of fluids. 
         FIG. 22  depicts a perspective view of an embodiment of a nipple assembly configured for the oral administration of fluids. 
         FIG. 23A  depicts a perspective view of an embodiment of a pacifier system that includes a nipple assembly and a cartridge. 
         FIG. 23B  depicts a cross-sectional view of the nipple assembly embodiment of  FIG. 23A . 
     
    
    
     DETAILED DESCRIPTION OF CERTAIN EMBODIMENTS 
     In the following detailed description, reference is made to the accompanying drawings, which form a part of the present disclosure. In the drawings, similar symbols typically identify similar components, unless context dictates otherwise. The illustrative embodiments described in the detailed description, drawings, and claims are not meant to be limiting. The detailed description is intended as a description of exemplary embodiments and is not intended to represent the only embodiments which may be practiced. The term “exemplary,” as used herein, means “serving as an example, instance, or illustration,” and should not necessarily be construed as preferred or advantageous over other embodiments. Other embodiments may be utilized, and other changes may be made, without departing from the spirit or scope of the subject matter presented here. It will be readily understood that the aspects of the present disclosure, as generally described herein, and illustrated in the Figures, can be arranged, substituted, combined, and designed in a wide variety of different configurations, all of which are explicitly contemplated and form part of this disclosure. 
     As noted above, embodiments described herein generally relate to apparatuses, systems, and methods of administering fluids or medical instrumentation to a patient, such as, for example, an infant child. One or more of the provided embodiments may overcome one or more of the drawbacks, limitations, or deficiencies that exist in the inpatient and outpatient markets. For example, in some embodiments, the apparatuses are single use, disposable, pre-loaded with a desired substance, configured to dispense a desired amount of fluid over a given period of time, and configured to dispense fluid upon actuation. In some embodiments, the apparatuses are actuated via sucking by the patient and/or pumping or squeezing by a care giver. In some embodiments, the apparatuses, systems, kits, and methods provide a more simple, efficient, and safe device for fluid administration. In some embodiments, the apparatuses are configured to receive and couple to various medical accessories to facilitate oral administration of medical instruments, when needed. The description herein provides examples of the apparatus, systems, kits, and methods according to various non-limiting embodiments. 
       FIGS. 1A-1D  illustrate a pacifier apparatus  100  in accordance with one embodiment of the present technology.  FIG. 1A  depicts an exploded side view of the embodiment, while  FIG. 1B  provides a perspective view,  FIG. 1C  provides a distal view, and  FIG. 1D  provides a cross-sectional view of the same embodiment. The apparatus  100  includes a rigid member assembly  110 , a balloon  120 , and a nipple assembly  130 , as shown in the exploded view of  FIG. 1A . The nipple assembly  130  of various embodiments includes a nipple base  132  and a nipple  134 . The nipple base  132  as depicted includes a distal face  131  and a proximal face  133 . The nipple  134  extends proximally from the proximal face  133  and includes a nipple wall  135  that defines a cavity  137  configured to hold fluid. The cavity  137  may be configured to hold any desired fluids, such as, for example, sucrose solutions and other analgesics, probiotic cultures, vitamins, nutritive solutions, colostrum, breast milk, antibiotics, anti-gas, over-the-counter medicaments, other liquid medicaments, and other fluids. The cavity  137  also may be configured to hold solution precursors, such as fluid-filled gel capsules and powders, which form a fluid solution upon exposure to the proper environmental trigger, such as, for example, heat and water, respectively. 
     In various embodiments, the nipple  134  is configured for sucking, such as within the mouth of a neonate or infant. As shown in  FIGS. 1C and 1D , an air opening  104  is located at a distal end  101  of the apparatus  100 . It should be understood that the air opening  104  can be located at any desirable location, not just the depicted location, and it can be of any suitable size and geometry. In some embodiments, the air opening  104  is configured to permit air or other gases to enter the chamber to prevent or minimize vacuum formation, wherein vacuum formation can prevent fluid from flowing out of the nipple aperture  136 . The nipple aperture  136  is located at a proximal end  102  of the apparatus  100 . In some embodiments, the configuration is designed to enable expulsion of fluid from the cavity  137  through the nipple aperture  136  and into the mouth of the neonate or infant, upon the nipple  134  being sucked. To facilitate sucking and fluid expulsion, in some embodiments, the nipple  134  is formed of a resilient and flexible material, including for example, one that is capable of non-permanent deformation. In one embodiment, the nipple  134  is formed of silicone. In other embodiments, the nipple  134  is formed of one or more of latex, plastic, rubber, another polymer, or a composite of polymers. 
     In some embodiments, the material characteristics of the nipple wall  135  and the size of the cavity  137  are carefully and purposefully selected. For example, in some embodiments, the cavity  137  is configured to hold a pre-determined volume of fluid. The cavity  137  can be configured to hold, for example, a recommended or desired dose of a medicament or fluid. The cavity  137  of some embodiments is sized to optimally hold, for example, 0.5-25 mL of fluid, or any individual value or sub-range therebetween. Additionally or alternatively, in some embodiments, the nipple size is tailored during the manufacturing process to comfortably fit within the average mouth size of a particular age group. Additionally, or in the alternative, in some embodiments, the thickness and flexibility of the nipple  134  and the size of the air opening  104  and the nipple aperture  136  are selected to form an apparatus  100  having a controlled flow rate of a predetermined value. As used herein, an apparatus can be said to have a controlled flow rate of a predetermined value if a fluid of a pre-selected viscosity flows from the nipple aperture  136  at a relatively steady average rate when subjected to a desired and constant rate of sucking, wherein each suck exerts a desired and constant force. For example, the size and material characteristics may be selected such that the apparatus  100  achieves an average flow rate that is most suitable for the fluid being administered, when the apparatus  100  is provided to an individual who sucks on the apparatus  100  with the same rate and force as an average child of an intended age group. The selected flow rate may be procedure-specific and/or age-specific, varying based on the fluid viscosity, recommended dose, and the average strength and rate of sucking performed by individuals in a target age group. 
     In one embodiment, such as the embodiment of  FIGS. 1A-1D , the nipple  134  and nipple base  132  are integrally formed as a unitary body. In other embodiments, the nipple  134  and nipple base  132  are formed separately and fused or otherwise affixed together during the manufacturing or use process. 
     When the apparatus  100  is fully assembled, the balloon  120 , depicted in  FIG. 1A , can be located in a passage within the nipple base  132  and/or within the cavity  137 . The balloon  120  of some embodiments is configured to transition from an undeployed or partially undeployed state to a deployed state or a nearly deployed state when the nipple  134  is sucked or squeezed. In a fully deployed state, the balloon  120  of some embodiments has an exterior size that is more or less the same size as the interior of the nipple wall  135 . Thus, in the fully deployed state, the balloon  120  substantially lines the interior of the nipple wall  135 . By transitioning towards a deployed state in response to the nipple  134  being sucked or squeezed, the deploying balloon  120  exerts force onto the fluid within the cavity  137 , facilitating expulsion of the fluid from the cavity  137  through the nipple aperture  136 . The directional force created by the balloon  120  filling into the cavity  137 , guides fluid towards the nipple aperture  136  regardless of the angle of the apparatus  100  or the user of the apparatus. Therefore, in such embodiments, fluid can be administered to an infant or child situated in any position, for example from 0 to 180 degrees from horizontal, that is, from laying horizontally to sitting or even leaning forward. Furthermore, in the deployed state, the balloon  120  effectively can at least partially or completely line and seal the cavity  137 , thereby preventing air from flowing from the air opening  104  through the nipple aperture  136 . In this manner, the apparatus  100  can be configured to limit a user&#39;s ingestion of air. The balloon  120  of various embodiments is formed, for example, from one or more of the following: a balloon, a sock, a sleeve, a bag, and any other membrane configured to transition from a limp, substantially undeployed state to an expanded, substantially deployed state that substantially lines the interior of the nipple wall  135 . In some embodiments, the balloon  120  is made of one or more of latex, low density polyethylene, other plastic or polymeric material, or any other suitable material. Moreover, while an apparatus having a balloon is described here and elsewhere in the specification, it should be understood that an appropriate equivalent to the balloon  120 , and one contemplated here, is any element adapted to move proximally within the cavity  137  in response to negative pressure being created in the cavity from sucking and/or in response to positive pressure being exerted on the element from a distal direction, such as, for example when a pump (described in detail below) is actuated. As one illustrative example, a slideable solid material, such as a stopper or plunger, may be used to perform the same function as the balloon  120  described herein. 
     It should be understood that the term “substantially undeployed can mean that the device is not more than 30% deployed, preferably less than 20%, less than 10%, less than 5%, less than 3%, 2%, or 1% deployed, or any value or subrange therein. The term “substantially deployed” can mean for example, that the device is from about 60% to 99.9% (or even 100%) deployed or any sub-range or value there between, for example, preferable at least 70%, 80%, 90%, 95%, 96%, 97%, 98%, or 99% deployed. Furthermore, the term “substantially line” can mean that the device lines from 60%-100% of the interior of the nipple or any subrange or value there between, for example, at least 70%, 80%, 90%, 95%, 96%, 97%, 98%, or 99%. 
     As shown in  FIG. 1D , the embodiment of  FIG. 1  also may include a passage wall  138  that defines a passage extending through the nipple base  134  from the distal face  131  to the proximal face  133 . In several embodiments, the passage may be centrally located in the nipple base  132  and axially aligned with a distal opening to the cavity  137 . Such a configuration allows for the positioning of a rigid member  112  within the passage and the positioning of a mouth  122  of the balloon  120  around the rigid member  112  with the body  124  of the balloon  120  then able to extend into the cavity  137  of the nipple assembly  130 . 
     In the depicted embodiment, the rigid member  112  (see, e.g.,  FIG. 1A ) extends into the passage of the nipple base  132  is provided to secure the balloon mouth  122  in a fixed position relative to the nipple base  132 . In some embodiments, a rigid member assembly  110  is also provided to help secure the rigid member  112 , and ultimately, the balloon  120  relative to the nipple base  132 . The rigid member assembly  110  can take many forms. In some embodiments, such as the one illustrated in  FIG. 1A-1D , the rigid member  112  is integrally connected to, and extends proximally from, a rigid plate  111 . 
     In some embodiments, the rigid plate  111  has a handle  116  extending distally from the rigid plate  111 . Such a handle  116  as depicted is configured to extend away from a user&#39;s face when the apparatus  100  is positioned within a user&#39;s mouth in order to facilitate insertion and removal of the apparatus  100  by the user or the user&#39;s caregiver. The handle  116  also can be positioned in other locations and/or directions. In the embodiment of  FIG. 1A-1D , the rigid plate  111  is positioned on the distal face  131  of the nipple base  132  and fixedly attached to the nipple base  132  through, at least, the use of one or more anchors  114 . Such anchors  114  extend proximally from the rigid plate  111  through anchor holes located within the nipple base  132 . The anchors may be in any desired configuration, for example, the depicted mushroom-shape, and they optionally can include threaded members having a screw head, or be of any other design that creates a secure connection between the nipple base  132  and the rigid member assembly  110 . In addition or in the alternative, the anchors  114  may extend distally from the distal face  131  of the nipple base  132  through anchor holes located within the rigid plate  111 . The anchors  114  may provide for a press fit, snap fit, screw fit, or any other desired connection. 
     In some embodiments, such as the apparatus embodiment depicted in the exploded view of  FIG. 2A , no anchors are present. Anchors are not necessary, for example, if the rigid member  112  and balloon mouth  122  are secured relative to the nipple base  132  through other fixation means. As illustrated in  FIGS. 2B and 2C , which respectively depict a distal view and cross-sectional view of the embodiment of  FIG. 2A , the rigid member  112  and rigid plate  111  are secured to the nipple base  132  using another suitable or desired approach, for example, an interference fit, ultrasonic welding, use of a polymeric adhesive or other adhesive means, etc. Alternatively, in some embodiments, over-molding is used during the manufacturing process to secure at least a portion of the rigid member assembly  110  within the nipple base  132 . Similarly, as shown in the distal view and cross-sectional view of a balloon  120  coupled to a rigid member assembly  110 , provided in  FIGS. 2D and 2E , respectively, the balloon  120  may be affixed to the rigid member  112  using any suitable fixation means. For example, in some embodiments, an industrial-strength adhesive or ultrasonic welding is used to secure the balloon. 
     In some embodiments, such as the ones illustrated in the perspective views of  FIGS. 3A, 3B, and 4A , the apparatus includes at least a nipple  134  and a nipple base  132 , as described above, and additionally, a pump  141 . The pump  141  serves as a primary or secondary mechanism for expelling fluid from the cavity  137  through the nipple aperture  136 . The pump  141  also can serve as a primary or secondary mechanism for deploying the balloon  120 , when such a balloon is present. It may be advantageous to provide a pump  141  on the distal end of the apparatus  100  to enable a caregiver to facilitate expulsion of the fluid. Such an embodiment may be particularly advantageous for administering fluid to premature neonates or others who cannot or are not sucking adequately. This configuration may also be advantageous during some procedures in which it is desirable to provide both light, fairly continuous flows of fluid, as is expressed during sucking, and larger aliquots of fluid administered at spaced intervals. In some embodiments, the apparatus with a pump is configured to provide metered (i.e., measured) doses of fluid. This configuration may be particularly advantageous in medical settings and other settings where a medicament is provided, as it is often extremely important to monitor the amount of medicament ingested. In some embodiments, the apparatus can expel a pre-measured amount, optionally at a measured flow rate. For example, in some embodiments, the apparatus is prefilled with a given amount or dosage of a fluid or product. During use of some such embodiments, the entire amount of pre-measured fluid or product may be expelled. In some such embodiments, the apparatus is configured to measure the amount of fluid expelled, such as for example, in instances where less than the total fluid in the apparatus is expelled. As an illustrative example, the apparatus may arrive filled with 5 mL of a fluid, but it may be desired that, for a particular infant, treatment, or procedure, only 3 mL be expelled. The apparatus of some embodiments is configured to provide a measurement of the expelled amount. For example, the apparatus of some embodiments includes measurement lines, such as, for example, the measurement lines  146  on the nipple  134  or on a syringe body  143 , which can be numbered and spaced to indicate the amount of fluid in, or expelled from, the device. 
       FIGS. 3A, 3B, and 4A  provide examples of pacifier apparatuses  100  having pumps  140 , for illustrative purposes only. The pump  141  of various embodiments may take any suitable, actuateable shape; for instance, as non-limiting examples, the pump may be bulbous, cylindrical, formed as a polyhedron, formed as a plunger, or formed as a syringe. Additionally, the pump  141  of various embodiments may be actuated in any desired way, for example, it can be compressible, depressible, and/or squeezable or can include any other appropriate pumping mechanism. In some embodiments, the pump  141  has an opening  104  positioned on a wall of the pump  141 ; the opening  104  may be accompanied with ribs, grooves, concave or convex features, or any other form adapted to facilitate user identification of the location of the opening  104 . The opening  104  of some embodiments is formed as a hole, slit, valve, or any other shape which enables the flow of air into an interior of the pump  141 . As an example, the pump  141  in  FIGS. 3A and 4A  can be actuated by covering the opening  104  with a finger, squeezing the pump  141  to move the pump walls closer together and to thereby move at least some existing air from the pump into the balloon, and releasing or uncovering the opening  104  to allow air inflow, which enables the pump  141  to return to its initial size and state. In other embodiments, the pump  141  may be actuated by pushing down on a rigid and slideable, or non-rigid, top portion of the pump  141 . For example, in  FIG. 3B , the pump (i.e., syringe)  141  can be actuated by depressing the plunger  144  down at least partially into a syringe body  143 . Using a pump formed as a syringe, such as, for example, the syringe  141  of  FIG. 3B , may advantageously allow a caregiver to monitor the amount of fluid dispelled during use of the apparatus. For example, even though air rather than fluid is present in the syringe body  143  of various embodiments, a measured depression of the plunger  144  causes movement of air from the syringe body  143  into the balloon or nipple cavity, which translates into a comparable or nearly comparable level of fluid expulsion from the nipple cavity through the nipple aperture  136 . 
       FIG. 4B  provides a distal view of the pacifier apparatus  100 , including the pump  141 , depicted in  FIG. 4A . The pump  141  extends from the distal side of the apparatus such that a caregiver can easily reach and actuate the pump  141  to express fluid through the nipple aperture  136 . 
       FIGS. 4C-4E  provide a cross-sectional view of the embodiment of  FIGS. 4A and 4B . Each of  FIGS. 4C-4E  depicts the same cross-sectional area and is provided to illustrate a balloon  120  transitioning from an undeployed (or substantially undeployed) state to a deployed (or substantially deployed) state. As shown in  FIG. 4C , in the undeployed state, the balloon  120  is limp and substantially retracted toward or into the passage or pump  141 . The depiction is not meant to be limiting; the balloon could be in any orientation, for example, compacted in the same plane as the base  132 , etc. In response to the nipple  134  being sucked and/or the pump  141  being actuated, an undeployed balloon  120  will begin to transition toward a deployed state. A non-limiting depiction of a partially deployed balloon  120  is illustrated in  FIG. 4D . As shown in the figure, when in a partially deployed state, the balloon  120  partially enters the nipple cavity  137 .  FIG. 4E  provides an illustration of a fully deployed balloon  120 . As visible in the illustration, in the fully deployed state, the balloon  120  is relatively comparable to the nipple wall  135  in size and shape. In such a state, the balloon  120  substantially lines an inner perimeter of the nipple wall  135 . 
     As with the non-limiting pump-less embodiments described above, in the embodiments that include a pump, there are numerous mechanisms for affixing or joining the various components together. Some embodiments that include a pump  141  also include a rigid member  112  designed to fixedly secure the balloon mouth  122  relative to the nipple assembly  130 . It should be understood that the rigid member can be a separate member or integral with some other component. In any case, the rigid member  112  is a component to which the balloon  120  can be attached in some embodiments. As illustrated in  FIG. 5A , the rigid member  112  of some embodiments is integrated into a rigid plate  111 .  FIG. 5A  depicts an exploded view of one embodiment of a pacifier apparatus  100  having a pump  141 .  FIGS. 5B, 5C, and 5D  depict the same embodiment through a perspective view, distal view, and cross-sectional view, respectively. In some embodiments, such as the one of  FIGS. 5A-5D , a second rigid member  113  is coupled to the rigid plate  111  such that one rigid member  113  extends distally and one rigid member  112  extends proximally from the rigid plate. Additionally, in some embodiments, such as the one of  FIGS. 5A-5D , the apparatus  100  further includes a pump base  142 . When present, the pump base  142  contains one or more through-holes  103  to allow for the passage of air from a distal side of the pump base  142  to a proximal side. Such through-holes  103  are also located in the nipple base  132  and the rigid plate  111 , when present in the apparatus  100 . The through-holes  103  in each element are positioned such that the through-holes of the various elements align and allow for the passage of air from a proximal side of the apparatus  100  to a distal side of the apparatus. The through-holes can function as a safety feature, helping to ensure that a child does not suffocate should the apparatus  100  become engulfed in the child&#39;s mouth or lodged in the child&#39;s airway. The pump as depicted in  FIGS. 5 and 6  can be actuated for example by applying force or pressure to the pump  141  in the direction toward the base  142 , for example, while covering the hole  104 . Upon uncovering the hole  104 , the pump can return to its original position and can then be actuated again if desired. 
     The pump base  142  of some embodiments is integrally connected with a proximal end of the pump  141 . In the embodiment of  FIGS. 5A-5D , one rigid member  113  is positioned within a passage that extends through the pump base  142  and the other rigid member  112  is positioned within the passage that extends through the nipple base  132 . The nipple assembly  130 , rigid member assembly  110 , and pump assembly  140  are fixedly connected, for example, through the use of anchors  114 ,  115 , some of which extend from a proximal face of the rigid plate  111  through holes located in the pump base  142  and some of which extend from a distal face of the rigid plate  111  through holes located in the nipple base  132 . In other embodiments, other means of connection may be used. 
       FIGS. 6A-6C  illustrate another embodiment of a pacifier apparatus  100  configured for the oral administration of fluid, which includes a pump  141 .  FIG. 6A  provides an exploded view of the pump assembly  140 , rigid member assembly  110 , balloon  120 , and nipple assembly  130 , while  FIGS. 6B and 6C  provide a distal view and cross-sectional view, respectively, of the fully assembled apparatus  100 . The apparatus  100  of  FIG. 6A  includes a pump  141 , which can be actuated, for example, by applying force or pressure to the pump  141  toward to the base  142  while covering the aperture  104 . Additionally or alternatively, the force can be provided by squeezing the pump  141  body to apply side or lateral pressure/force to the pump. In this illustrated embodiment, the rigid plate  111  of the rigid member assembly  110  lacks any anchors. Thus, the rigid plate  111  may be affixed to the pump assembly  140  and nipple assembly  130  by applying an industrial strength adhesive, performing ultrasonic welding, using over-molding, or through any other suitable fixation method. 
     In some embodiments of the pacifier apparatus  100 , such as the one illustrated in  FIGS. 7A-7C , the rigid member  112  extends proximally from the pump base  142 . Such a configuration may be present in designs where the rigid plate  111  is built or over-molded into the pump base  142 . Such a design is most visible in  FIG. 7C . Such a configuration may also be present in designs in which the rigid member  112  is integrally connected and formed with the pump base  142 . In such embodiments, the balloon  120  is affixed to the rigid member  112 , the rigid member  112  is affixed into the passage of the nipple base  132 , and the pump base  142  is directly coupled to the nipple base  132 . Previously mentioned fixation methods or any other suitable forms of fixation may be used. In some embodiments, the coupling of the nipple base  132  and pump base  142  is reinforced with the addition of anchors. The anchors may extend proximally from the pump base  142  for insertion through holes within the nipple base  132 . Additionally or in the alternative, anchors may extend distally from the nipple base  132  through holes within the pump base  142 . Similar to the apparatus  100  of  FIG. 6A , the apparatus  100  of  FIG. 7  includes a pump  141 , which can be actuated by applying force to the pump  141 . The force can be applied by squeezing the sides together or by applying pressure toward the base in a proximal direction. If present, the aperture  104  can be covered in order to create pressure within the device. 
       FIGS. 8A-8D  illustrate an embodiment of a pacifier apparatus  100  having a modified pump assembly  140 . The pump assembly  140  of the depicted embodiment includes no pump base; instead, the rigid member  112  and anchors  114  extend directly from a proximal side of the pump  141 . In such an embodiment, the pump assembly  140  is securely fastened to the nipple assembly  130  by affixing the rigid member  112  to the passage wall of the nipple base  132  and by inserting the anchors  114  into anchor holes  139  in the nipple base  132 . In other embodiments, the anchors  114  may extend distally from the nipple base  132  for insertion into the pump  141 . The pump  141  of  FIGS. 8A-8D  can be actuated, for example, by applying pressure or force to the pump  141 . The optional aperture  104 , if present, can be covered to allow internal pressure to be generated when the pump is pressed or squeezed, as desired. 
     An additional or alternative attachment mechanism is illustrated in the embodiment of  FIGS. 9A-9C . As shown in the exploded view of  FIG. 9A , a locking ring  150  is provided to reinforce attachment of the balloon  120  and rigid member  112  to the nipple base  132 .  FIG. 9B  provides a distal view of the same embodiment. In this embodiment, the balloon mouth  122  is positioned so as to engulf an outer perimeter of at least a proximal portion of the rigid member  112 . In an alternate embodiment, the balloon mouth  122  is affixed to an inner perimeter of a rigid member  112 . In either embodiment, the locking ring  150  is positioned around the rigid member  112 . The locking ring  150  may be positioned around a distal portion of the rigid member  112 , around the entire rigid member  112 , or around the balloon mouth  122  at a proximal portion of the rigid member  112 . The locking ring  150  is also securely attached to the nipple base  132  within the passage. In some embodiments, the locking ring  150  is integrally incorporated into the nipple assembly  130 , for example, in embodiments in which over-molding is used in the manufacturing process to build the nipple base  132  around the locking ring  150 . 
     As is visible in  FIG. 9A  and the cross-sectional view of  FIG. 9C , in some embodiments, one of the rigid member  112  or locking ring  150  includes a groove, depression, indentation, or other recess (e.g.,  117 ) while the other of said rigid member  112  or locking ring  150  includes a ridge, ledge, protrusion or the like (e.g.,  151 ) configured to fit within the recess  117  in order to restrict movement of the rigid member  112  and balloon  120  in the distal and proximal directions. In addition or in the alternative, one of the rigid member  112  or locking ring  120  includes one or more tabs, teeth, or other protrusions (e.g.,  118 ) while the other of said rigid member  112  or locking ring  150  includes one or more slots or depressions each configured to receive a protrusion  118 . Such a feature may be included to limit the rotational movement of the rigid member  112  and balloon  120  relative to the nipple assembly  130 . In some embodiments, the rigid member  112  may be snapped or pressed into fixed engagement with the locking ring  150 . In other embodiments, the rigid member  112  and locking ring  150  may include complementary threading such that the rigid member  112  can be screwed into fixed engagement with the locking ring  150 . The pump  141  can be actuated as described elsewhere herein. 
       FIGS. 10A-10C  illustrate an additional embodiment of a pacifier apparatus  100  configured for the oral administration of fluid. As best shown in the cross-sectional view of  FIG. 10C , no attachment mechanisms are needed, because the apparatus  100  includes an integral, unitary body. For example, the apparatus can be made or manufactured by molding or any other suitable method to make such a unitary and/or integral apparatus. A perspective view and a distal view of this unitary body design are provided in  FIGS. 10A and 10B , respectively. As is true for above-mentioned embodiments, the present embodiment includes, at least, a nipple  134 , a nipple base  132 , and a cavity  137  configured to hold fluid. In this embodiment, the cavity  137  is defined by both a nipple wall  135  and a portion of a proximal face  131  of the nipple base  132 , wherein said portion is enclosed by the nipple wall  135 . The cavity  137  of some embodiments is closed but for a nipple aperture  136  on a proximal tip of the nipple  134  and an optional opening  104  on a distal end of the cavity  137  which extends through the nipple base  132 . The opening  104 , if present, is configured to allow for the passage of air into the cavity  137  to enable sucking and/or to prevent the nipple wall  135  from collapsing. 
     In some embodiments, the opening  104  is in the form of a small pinhole or a slit. In some embodiments, the opening  104  includes a valve. In other embodiments, the opening  104  includes a frangible seal configured to seal fluid within the cavity  137  until the seal is ruptured just prior to use. The opening  104  may include any other form of hole or passage which is small enough to limit fluid from leaking from the opening during shipping and large enough to allow for sufficient passage of air. The opening  104  may be covered with a sticker or other removable seal to prevent fluid from spilling from the cavity during shipping. Such features of the optional opening  104  may be present in any of the pacifier apparatus embodiments and Figures described herein. 
     In various embodiments of the unitary apparatus, the size of the opening  104  and the size of the nipple aperture  136 , as well as the size of the cavity  137  and the thickness of the nipple wall  135  may be selected so that the apparatus  100  achieves a desired cavity pressure and a desired average flow rate when sucked on by an individual with an average sucking force and sucking rate equal to the average sucking force and sucking rate expected within the age group for which the apparatus  100  is tailored. 
     In some embodiments, such as the embodiment of  FIGS. 10A-10C , the apparatus has no removable parts. Such a pacifier apparatus  100 , which is capable of controlled flow while also having a unitary body design, may provide some advantages. The embodiment of  FIGS. 10A-10C  is simple to manufacture, is low cost, and lacks potentially separable and therefore potentially hazardous parts. In some embodiments, such as the one depicted in  FIGS. 10A-10C , an optional handle  116  extends from the distal face  131  of the nipple base  132 . The handle  116  also may be part of the unitary body design. 
     In other embodiments of a pacifier apparatus  100  having a unitary design, such as the embodiment of  FIGS. 11A-11C , a pump  141  extends from the distal face  131  of the nipple base  132 . The pump of some embodiments includes one or more compressible walls  145 . As visible in the cross-sectional view of  FIG. 11C , in some embodiments having a unitary body with a pump  141 , the nipple wall  135  and compressible wall  145  each connect to a passage wall  138  in the nipple base  132 , and together, the nipple wall  135 , the compressible wall  145 , and the passage wall  138  define the cavity  137 . In some embodiments, the cavity  137  may constrict at the location of the nipple base  132 . As in above-mentioned embodiments of an apparatus  100  having a pump  141 , in the embodiment of  FIGS. 11A-11C , fluid can be expelled from a nipple aperture  136  at a proximal end of the nipple  134  by sucking or squeezing the nipple  134  and/or by compressing, depressing, or otherwise squeezing the pump  141 . The apparatus  100  having a unitary body may be formed of any suitable material, for example, one or more of silicone, plastic, rubber, or other polymer, composite, or material that is safe for children and non-permanently deformable. 
     An embodiment of a pacifier system is depicted in  FIGS. 12A-12D . As shown in the exploded view of  FIG. 12A , the pacifier system  1200  of the current embodiment includes: a pacifier apparatus in the form of a nipple assembly  130 , and an insertable cartridge  200 . The nipple assembly  130  includes a nipple  134  and a nipple base  132 . The nipple  134  extends proximally from the nipple base  132  and includes a nipple wall  135 , which defines the perimeter of a nipple cavity  137 . In some embodiments, the nipple wall  135  has one or more thickened or contoured regions, for example, to create a nipple cavity  137  that is complementary in size and shape to the cartridge  200 , which the nipple assembly  130  is configured to receive. A passage extends through the nipple base  132  providing an opening to the cavity  137  from a distal end of the nipple assembly  130 . As in other embodiments, the nipple is configured for sucking and has a nipple aperture  136  at a proximal end of the nipple  134 , which provides an outlet through which fluid can flow out of the cavity  137 . As shown in the perspective view of  FIG. 12B , the distal view of  FIG. 12C , and the cross-sectional view of  FIG. 12D , the insertable cartridge  200  is configured to securely couple to the nipple base  132  such that, when engaged, at least a portion of the insertable cartridge  200  is coupled to or positioned within the passage and the cavity  137 . The insertable cartridge  200  of various embodiments securely couples to the nipple base  132  via threading, a snap fit, or other non-permanent attachment means. The insertable cartridge  200  of some embodiments has a proximal cartridge portion, which includes a reservoir  215  configured to hold a fluid and a cartridge aperture  212  at a proximal tip of the cartridge  200 . The insertable cartridge  200  of some embodiments also has a distal cartridge portion, which includes a cap  220  and a pump  222 . In the embodiment of  FIGS. 12A-12D , the pump  222  is not a separate element, but rather forms a portion of the cap  220 . The pump  222  of the illustrated embodiment is a compressible pump configured to be squeezed and non-permanently deformed, for example, between the fingers of a caregiver. In other embodiments, other pump designs may be used, such as for example, a syringe plunger. 
     When the insertable cartridge  200  is engaged with the nipple assembly  130 , the pacifier system  1200  is configured to expel a fluid from the reservoir  215  through the cartridge aperture  212  and out of the nipple assembly  130  through the nipple aperture  136  at least in response to the pump  222  being actuated. In some embodiments, fluid may also be expelled from the reservoir  215  and out the cartridge aperture  212  and the nipple aperture  136  in response to the nipple  134  being sucked. While the cartridge depicted in  FIG. 12A  has the depicted shape and design, other shapes and designs are contemplated. For example, rather than a pointed tip at aperture  212 , the end of the cartridge can be round, for example. In some embodiments, the proximal end of the cartridge  220 , when fully inserted into the nipple assembly, contacts an inner proximal end of the nipple or comes very close to contacting a proximal end of the nipple, for example. In one embodiment (not shown), the cartridge is shaped as a syringe body. In such an embodiment, the pump is formed of a plunger, which is configured to be depressed down into the syringe body. In various embodiments, the insertable cartridge  200  may be removed from the apparatus  100  when no longer in use, allowing an individual to continue sucking on the nipple assembly  130 . In some embodiments, the cartridge  200  is disposable and configured for a single use. In other embodiments, the cartridge  200  may be reusable and have, for example, a removable cap  220 , which a caregiver can remove to fill the cartridge  200  with an amount of fluid. 
     An additional embodiment of a pacifier system is depicted in  FIGS. 13A-13C . The pacifier system  1300  includes a pacifier apparatus in the form of a nipple assembly  130 , and additionally, a cartridge  300 . The nipple assembly  130  includes a nipple  134  and a nipple base  132 . 
     The pacifier system embodiments formed from a pacifier apparatus and a cartridge, such as, for example, the embodiments depicted in  FIGS. 12A-13C  may be packaged and sold as an interchangeable kit, for example. In one embodiment, the kit includes a plurality of insertable cartridges, for example cartridges  200  or  300 , with each cartridge containing a predetermined volume of a predetermined fluid. Each cartridge within the kit may be configured for a single use. In some embodiments, the kit also includes one or more pacifier apparatuses having some or all of the characteristics of the above-described nipple assembly  130 . The nipple assembly  130  embodiments described herein may be adapted for one-time use or they may be reusable. The nipple assembly  130  of various embodiments is configured to couple to a plurality of cartridges individually, and interchangeably. In addition or alternatively, as described in more detail below, the nipple assembly  130  may be configured to couple to more than one cartridge at a time. For example, one cartridge may be prefilled with sucrose, while the second cartridge is prefilled with a medicament. In some embodiments, the nipple assembly  130  is configured to couple to cartridges having reservoirs of varying sizes intended to hold varying amounts of fluid. 
     The nipple assembly  130  of  FIGS. 13A-13C  is depicted in  FIGS. 14A-14D  in more detail. As in other embodiments, the nipple  134  extends proximally from the nipple base  132  and the shape of the nipple  134  is defined, at least in part, by a contoured nipple wall  135 . In the depicted embodiment, the nipple wall  134  defines the perimeter of a nipple cavity  137 . In some embodiments, and as shown in  FIGS. 14A-14D , a receiving tube  160  is disposed within the nipple  134 , for example, within the nipple cavity  137 . In some embodiments, a plurality of receiving tubes may be disposed within the nipple cavity  137 . In various embodiments, the one or more receiving tubes  160  are fixedly attached to, or formed in connection with, a proximal, inner portion of the nipple wall  135 . In some embodiments, the one or more receiving tubes  160  are held in place, at least in part, by one or more support struts  162 ; in other embodiments, no support struts  162  are present. Additionally or alternatively, in some embodiments, the one or more receiving tubes  160  are supported, at least in part, by one or more regions of thickened nipple wall  135 , which contact the receiving tube  160  within the nipple cavity  137  and/or in the passage of the nipple base  132 . 
     In other embodiments, such as, for example, the nipple assembly  130  embodiment of  FIGS. 15A-15D , the nipple wall  135  has one or more thickened regions, which partially fill in a portion of the nipple  134  such that an inner portion of the nipple wall  135  defines a lumen. In such embodiments, this lumen forms the receiving tube  160 . In such embodiments, the thickness and diameter of the nipple wall  135  may be constructed to prevent the nipple  134  from collapsing in the absence of support struts  162 . In some embodiments, the material and thickness of the nipple wall  135  are selected such that applying a sucking force to the nipple  134  can cause the receiving tube  160  to non-permanently deform and contract radially inward toward a central axis  158 . In some embodiments, the material and thickness of the nipple wall  135  are selected such that an average sucking force of a child can cause a diameter of the receiving tube  160  to narrow at least 1% to 90%, 95%, 96%, 97%, 98%, or 99%, or any sub-range or value therebetween. In some embodiments, a region of the nipple wall  135  may be thinner than the surrounding nipple wall  135  such that the region is more prone to contraction around the receiving tube  160  at that region. In some embodiments, the receiving tube  160  may be manufactured in a contracted state, and a pressure force, such as a syringe or cartridge expelling a fluid inside the receiving tube  160 , may cause a diameter of the receiving tube  160  to expand radially outward. 
     In various embodiments, such as, for example, the nipple assembly  130  embodiments of  FIGS. 14A-14D and 15A-15D , the receiving tube  160  extends through the nipple  134 , and optionally, into the passage of the nipple base  132 , and optionally, distally beyond the distal face  131 . In various embodiments, the receiving tube  160  can be accessed from a distal side of the nipple assembly  130 , and the receiving tube  160  is sized and configured to receive a cartridge  300  from the distal side of the nipple assembly  130 . In some embodiments, the receiving tube  160  is uniform in shape; in other embodiments, it includes one or more fitted features, such as, for example, an expanded distal tube portion  164 , configured to securely receive a portion of the cartridge  300  or a portion of a medical instrument. For example, in some embodiments, the expanded distal tube portion  164  is configured to receive and couple to a cartridge spout (for example, the cartridge spout  320  of  FIGS. 16A-16F ) such that the cartridge spout  320  terminates within the expanded distal tube portion  164  and fills all or substantially all of the expanded distal tube portion  164 . 
     In other embodiments, the receiving tube  160  includes three distinct portions, for example, an expanded distal tube portion  164 , a medial tube portion  163 , and a proximal tube portion  162  (see, for example,  FIG. 23B ). In some such embodiments, the medial tube portion  163  has a smaller diameter than the expanded distal tube portion  164 , and the proximal tube portion  162  has a smaller diameter than the medial tube portion  163 . In some embodiments, for example, the embodiment depicted in  FIGS. 23A-23B , the medial tube portion  163  is tapered so as to funnel fluid from a cartridge spout  320  or other fluid-delivering instrument within the expanded distal tube portion  164  to the narrower proximal tube portion  162 . In some embodiments, the gradual or progressive narrowing of the receiving tube  160  helps regulate and control fluid flow. In some embodiments, the gradual or progressive narrowing of the receiving tube  160  is designed to funnel fluid toward the nipple aperture  136  to facilitate the extrusion of all fluid from the receiving tube  160 . Such a design may prevent fluid from getting stuck within the nipple assembly  130 ; that is, such a design may eliminate or minimize dead space. The receiving tube may have any suitable length and diameter. For example, the length may be selected to ensure the receiving tube  160  extends the length of the nipple, through the passage of the nipple base, and at least slightly beyond the distal end of the nipple base. For example, the receiving tube may extend 1 mm to 10 cm beyond the distal end of the nipple base. In some embodiments, the receiving tube is sized and shaped to contain a volume of fluid between 0.01 cc&#39;s and 0.5 cc&#39;s. The receiving tube  160  of some embodiments has an inner diameter between 0.01 mm and 12.0 mm, and preferably between 0.07 mm and 7.0 mm, and the inner diameter may include any sub-range or individual value therebetween. The selected diameter of the receiving tube  160  may depend on the size of the healthcare accessory to which the receiving tube  160  is configured to couple. 
     In several embodiments, the receiving tube  160  of the nipple assembly  130  is configured to couple, either directly or indirectly, to various accessories, making each of these nipple assembly  130  embodiments a versatile tool for administering fluid and/or orally-administered medical instruments to young, infirmed, or disabled populations. As non-limiting examples, in some embodiments, the nipple assembly  130  is configured to couple to luer lock syringes and enteral feeding syringes of various geometries and to extrusions such as extrusion tubing connected to powered and non-powered devices. In some embodiments, the nipple assembly  130  is configured to couple to intra-esophageal catheters, imaging scopes, intubation tubes, transitional feeding attachments, and other orally-delivered medical instrumentation. As shown, for example, in  FIG. 15D , some embodiments of the nipple assembly  130  have a recessed portion  166  within a passage of the nipple base  132  between the inner receiving tube  160  and the walls of the nipple base  132 . The recessed portion  166  of some embodiments is designed to allow enteral feeding syringes or other instrumentation to couple to the receiving tube  160 . Further, in some embodiments, the recessed portion  166  allows for any medication or fluid that may have leaked from a cartridge during insertion into the receiving tube  160  to be quickly and cleanly retrieved. The recessed portion  166  of various embodiments may be of any suitable shape and size, and the walls defining the recessed portion  166  may be positioned at any desirable angle. 
     The nipple assembly  130  embodiments depicted in  FIGS. 14A-15D  also have a handle  116  extending from the base  132  for easy insertion and removal of the nipple assembly  130  by a healthcare provider, for example, from the mouth of an infant and/or patient. As in other embodiments, the nipple  134  is configured for sucking and has a nipple aperture  136  at a proximal end of the nipple  134 , which provides an outlet through which fluid can flow out of the cavity  137 . 
       FIGS. 16A-16F  depict various views of the cartridge  300  embodiment shown in the pacifier system  1300  of  FIGS. 13A-13C . The cartridge  300  includes a cartridge body  310  defining a reservoir configured to house a fluid, such as, for example, a medicament, nutritional supplement, or analgesic. The cartridge  300  also includes a proximal cartridge spout  320  configured to fit within the receiving tube  160  of the nipple assembly  130 . In some embodiments, at least a portion of the cartridge body  310  is flexible and/or deformable, for example, to allow a healthcare provider to squeeze the cartridge body  310  to urge fluid out of the reservoir, through the spout  320 , out a cartridge aperture  330 , and into the receiving tube  160  of the nipple assembly  130 . 
     In some embodiments, the cartridge  300  is prefilled with a pre-measured dose of a liquid. The size of the reservoir, and therefore, the surrounding cartridge body  310 , may vary depending on the amount of liquid provided within the cartridge  300 . In some embodiments, the cartridge  300  contains 0.01 mL to 10.0 mL of liquid, or any sub-range or individual value therebetween. For example, in some such embodiments, the cartridge  300  contains 0.1 mL to 5.0 mL of liquid. In one non-limiting example, the cartridge  300  is sold prefilled with 2.0 mL of liquid. 
     As shown in  FIGS. 16A-16C , before use, some embodiments of a cartridge  300  include a cartridge seal  340 . In such embodiments, the cartridge seal  340  prevents fluid from leaking out of the cartridge spout  320  prior to use. In some embodiments, the cartridge seal  340  also acts as a hermetic seal, maintaining a sterile environment within the spout  320  and reservoir of the cartridge  300  prior to use. In some embodiments, the seal  340  can be fully torn off, cut off, or otherwise removed by a user prior to use. The connection between the seal  340  and the cartridge  300  of some embodiments is perforated or indented, for example, to facilitate breakage of the seal  340  from the cartridge  300 .  FIGS. 16D-16F  provide views of the cartridge  300  with the cartridge seal  340  fully removed. In other embodiments, only a proximal portion of the seal  340  is configured to be broken off and detached from the cartridge spout  320  so as to expose the cartridge aperture  330 . In some such embodiments, the seal  340  is configured to flex and bend at one or more locations, for example, at a perforation line located on the seal  340  between the detachable portion and a permanently attached portion, thereby allowing the proximal portion of the seal  340  to be broken and moved out of the way while maintaining its attachment to the cartridge body  310 . 
     In some embodiments, a tab  350  remains attached to a distal end of the cartridge body  310  after the seal  340  is torn. The tab  350  of some embodiments acts as a handle, facilitating cartridge&#39;s  300  insertion into, and removal from the nipple assembly  130 . 
     In some embodiments of the cartridge  300 , at least a portion of the cartridge body  310  is flexible and deformable. In some embodiments a significant portion of the body  310  is deformable, for example, at least the entire bulbous portion. In some embodiments, the cartridge body  310  allows for repeatable actuation of a substance, for example a fluid, with all or some of the cartridge body  310  non-permanently deforming with each actuation. In some embodiments, two or more recessed finger gripping portions  360  are provided to facilitate gripping; in some such embodiments, the finger gripping portions  360  are less flexible than the bulbous portion, so as to limit unintentional expulsion of fluid during insertion or removal of the cartridge  300  from a pacifier apparatus. Additionally, in some embodiments, the gripping portion  360  has a plurality of defined edges, which create tension and shape memory within the cartridge body  310 , such that following an actuation of the cartridge body  310 , the cartridge body  310  will return to its original position. In various embodiments, pressing on a portion of the cartridge body  310  actuates the cartridge  300 , causing the liquid stored inside the reservoir of the cartridge  300  to flow through the cartridge aperture  330  and out the nipple aperture  136 . Additionally or alternatively, in some embodiments, the cartridge body  310  may deform from negative pressure created when an infant or other individual sucks on the nipple  134  of the attached nipple assembly  130 . Alternatively, in embodiments not shown, the cartridge body  310  may deform permanently; in some such embodiments, the deformation may serve as a visual indicator to a user that a liquid or substance has been expelled through the cartridge aperture  330 . 
     In various embodiments, the spout  320  is sized and shaped to fit securely within the receiving tube  160  of a nipple assembly  130 . In some embodiments, the spout  320  has an outer diameter between 0.01 mm and 12.0 mm, and the spout diameter may include any sub-range or individual value therebetween. In some embodiments, the diameter of the spout  320  is between 0.06 mm and 6.0 mm. In some embodiments, the diameter of the spout  320  is uniform. In other embodiments, the spout  320  is tapered such that the spout  320  narrows in a proximal direction; in such embodiments, both the largest outer diameter of the spout  320  and the smallest outer diameter of the spout  320  are within the ranges provided above. In various embodiments of the nipple assembly  130 , the diameter of the receiving tube  160  is slightly larger than the cartridge spout diameters to which it couples, such that at least a portion of an inner wall of the receiving tube  160  is in contact with at least a portion of an outer wall of the spout  320 . 
     In various embodiments, the height and diameter dimensions of the cartridge  300  are selected so as not to pose a choke hazard to young children. For example, in some embodiments, the diameter of the cartridge  300  is at least 1.25 inches. Additionally or alternatively, in some embodiments, the height of the cartridge  300  is at least 2.25 inches. As shown in  FIGS. 16A-16F , in some embodiments, the cartridge seal  340  runs at least the length or substantially the length of the cartridge  300  such that, when detached to open the cartridge aperture  330 , no aspect of the broken seal  340  poses a choking risk. Accordingly, the cartridge  300  of some embodiments is formed such that, when separated, both the seal  340  and the remainder of the cartridge  300  independently conform to choke hazard regulations. For example, when detached, the cartridge seal  340  of some embodiments also has a diameter or width of at least 1.25 inches and/or a height of at least 2.25 inches. In one non-limiting example, the length of the cartridge  300  from a distal tip of the tab  350  to the proximal tip of the cartridge aperture  330  is approximately 2.5 inches; the length of the removable seal  340  at its longest location is approximately 3.1 inches; and the length of the pacifier apparatus  100  with the cartridge  300  securely positioned within the nipple assembly  130  is approximately 3.3 inches. In another embodiment, the length of the cartridge  300  and the length of the seal  340  is 2.25 inches, 5 inches, or any value therebetween. In another embodiment, the diameter or width of the cartridge  300  and the diameter or width of the seal  340  is 1.25 inches, 3 inches, or any value therebetween, for example, 1.5 inches or about 1.5 inches. In other embodiments, other dimensions are selected. In some embodiments, the seal  340  is not fully detachable from the cartridge  300  but rather is permanently attached to the cartridge  300  at one or more sites remote from the cartridge aperture  330 . In some such embodiments, the portion of the seal  340  that is moveable may be sized to pass choke test standards. In other such embodiments, the moveable portion of the seal may have a maximum length smaller than 2.25 inches and a maximum width smaller than 1.25 inches. In some embodiments in which the seal  340  is not fully detachable, the seal  340  is formed of a material having sufficient strength to withstand considerable force without full separation from the cartridge  300 . In various embodiments, both the cartridge  300  and the seal  340  are each configured to withstand considerable force without failing. Failure may include cracking, breaking, separation of a portion configured to be permanently coupled, or deforming to a shape that would prevent the cartridge  300  or the seal  340  from passing choke test standards. For example, in some embodiments, the seal  340  and the cartridge  300  are able to withstand at least 0.5 pounds, 20 pounds, or any value therebetween of force, such as torque or tension, without failing. In one embodiment, the seal  340  and the cartridge  300  are each able to withstand at least 1 pound of force without failing; in another embodiment, the seal  340  and the cartridge  300  are able to withstand at least 5 pounds of force without failing. In some embodiments, any or all of the cartridge  300  components are formed of a plastic, silicone, rubber, other polymer of polymer composite, or any other suitable material. 
     While the cartridge  300  of various embodiments may be coupled to a nipple assembly  130  as described herein to form a complete pacifier apparatus or system, the cartridge  300  of some embodiments may additionally or alternatively be used independently to administer fluids to individuals. For example, the systems of hermetically sealed cartridges filled with liquid described herein may be positioned directly into an individual&#39;s mouth. In use, an individual may suck directly from the cartridge aperture  330  or the cartridge  300  may be squeezed such that the liquid is expelled from the cartridge aperture  330  directly onto the inner cheek or the tongue of an individual. 
       FIGS. 17A-17E  depict various views of a nipple assembly  130  embodiment configured for use with a cartridge, such as, for example, the cartridge of  FIGS. 16A-16F . As shown in the various views, the nipple assembly  130  of the present embodiment includes a plug  170  and a strap  180 . The strap  180  functions to secure the plug  170  to the nipple assembly  130 . In some embodiments, the strap  180  is flexible and may be rounded, flat, or any other suitable shape or configuration. In some embodiments, the strap  180  has a first end attached to the nipple base  132  and a second end attached to the plug  170 . In some embodiments, the plug  170  has a first portion  172  with ribs, depressions, traction pads, or other features configured to facilitate gripping of the plug  170  by a caregiver. In other embodiments, ribs, depressions, or other traction features may be formed or disposed on the strap  180 . The plug  170  of some embodiments has a lateral portion  174  sized and configured to securely fit within a portion of the receiving tube  160 . The plug  170  is provided for insertion into a distal end of the receiving tube  160  when no cartridge  300  is secured within the receiving tube  160 . When the lateral portion  174  of the plug  170  is placed within the distal end of the receiving tube  160 , the plug  170  is configured to fully or substantially occlude the flow of air into the receiving tube  160  from the distal end. In some embodiments, the plug  170  functions to minimize a fluid-receiving individual&#39;s ingestion of air through the pacifier apparatus. Additionally, some embodiments of the plug  170  include a medial portion  176  sized and configured to securely fit within a through-hole  103  of the nipple base  132 . Such a configuration allows the plug to be placed into a through-hole  103  and out of the way of the user when a cartridge  300  is in position within the receiving tube  160 . In other embodiments, the entirety of the plug  170  or a substantial portion of the plug  170  fits securely within both the receiving tube  160  and one or more through-holes  103 . 
       FIG. 18  depicts an additional embodiment of a pacifier apparatus in the form of a nipple assembly  130  configured for use with a cartridge, such as, the cartridge of  FIGS. 16A-16F .  FIG. 18  depicts three non-limiting examples of possible placements of the plug  170  and the strap  180  in relation to the nipple base  132 . 
     An additional embodiment of a pacifier apparatus in the form of a nipple assembly  130  is provided in  FIG. 22 . The depicted nipple assembly  130  of the present embodiment includes a valve  182 . A cartridge  300 , medical instrumentation, or a connector may couple to the valve  182 . In some embodiments, the valve  182  functions to occlude the receiving tube  160  in order to prevent ingestion of air by an individual sucking on the nipple  134  when no cartridge  300  or similar apparatus is coupled to the receiving tube  160 . In some embodiments, the valve  182  is provided in addition to a strap  180  with a plug  170 . In other embodiments, the valve  182  eliminates the need for the plug  170  and the strap  180 . In some embodiments, the valve  182  includes a connector portion, such as, for example, valve threads  184 , which may be located external or internal to the receiving tube  160 . The valve  182  of various embodiments also includes a fluid occluding portion internally disposed within the receiving tube  160 . In some embodiments, the fluid occluding portion of the valve  182  is positioned within the expanded distal portion  164 , for example, at the proximal end of the expanded distal portion  164 . In other embodiments, the fluid occluding portion of the valve  182  is positioned within the medial tube portion  163  or the proximal tube portion  162 . The fluid occluding portion of the valve  182  is configured to transition from a closed state to an open state when acted upon by a sufficient force. For example, the valve  182  of  FIG. 22  remains in a closed state until acted upon by a force such as expulsion of fluid from the cartridge  300 . In other embodiments, the valve  182  is positioned to open when a cartridge  300  is inserted into the receiving tube  160 . The valve  182 , in some embodiments, is configured to transition from a closed state to an open state when a pressure greater than 2 kilopascals (kPa) is acted on it. In other embodiments, the valve  182  transitions to an open state when a pressure greater than 44 kPa acts on it. In still other embodiments, the minimum pressure needed to transition the valve from a closed state to an open state is an individual value between 2 kPa and 44 kPa, for example, 5 kPa, 10 kPa, 15 kPa, 20 kPa, 25 kPa, 30 kPa, 35 kPa, or 40 kPa. Additionally or alternatively, the valve  182 , in some embodiments, is designed to withstand a minimum negative pressure of 200 mmHg without transitioning out of the closed state. Such a pressure may, for example, be exerted by the sucking of an aged one- to thirty-day post-partum infant. 
     The valve  182  of some embodiments is formed of a material or composite of materials selected from the group consisting of: silicone, rubber, plastic, and other polymers. In other embodiments, any other suitable material may be used. In some embodiments, the valve  182  has an internal diameter taper ratio between 0.140″ and 0.300″, while the valve threading  184  has an outside diameter between 0.200″ and 0.500″. The valve  182  may be molded into the receiving tube  160 . In some embodiments, the valve  182  replaces the expanded distal tube portion  164 . In other embodiments, the valve  182  may be overmolded to the receiving tube  160 , for example, using materials and polymers known to withstand greater than 300° melting temperatures. In yet other embodiments, the valve  182  may be fixedly attached to the receiving tube  160  by gluing, ultrasonically welding and/or through other adhesive means. In another embodiment, manufacturing a valve  182  within the receiving tube  160  includes forming a valve  182 , separately forming a nipple assembly  130  having a receiving tube  160  with an expanded distal tube portion  164  molded to fixedly retain the valve  182 , and upon demolding of the nipple assembly  130 , promptly placing the valve  182  within the expanded distal tube portion  164 . As the molded polymers or other materials forming the nipple assembly  130  cool, they contract and fixedly secure around and upon the valve  182 . The valve  182  of some embodiments is constructed to withstand separation from the receiving tube  160  at least when a tension force up to 10 lbs is exerted on it in any direction from the nipple assembly  130 . 
     The valve  182  and valve threads  184  are designed to couple to a variety of specialty syringes and connectors, such as those found in neonatal feeding syringes and syringe extenders. In some embodiments not shown, the valve  182  may connect to such devices without the valve threads  184  but through a slip-fit, snap fit, friction fit, or other coupling means. In some embodiments, the valve  182  is sized and shaped to prevent coupling with traditional luer lock tapered syringes or with syringes of certain sizes. In one such embodiment, the valve  182  is molded such that the diameter of the valve threads  184  has a size and shape that enables coupling to oral syringes but not luer lock syringes. For example, in one embodiment, the valve  182  with the valve threads  184  has an outer diameter between 0.20″ and 0.50″, which prevents traditional luer lock designs from coupling. Such a safety feature may be helpful in a clinical setting to reduce errors; specifically, such a feature may help ensure that the nipple apparatus  130  is only coupled to devices intended for oral administration, such as oral syringes, and not intravenous syringes. 
       FIG. 23A  illustrates one embodiment of a system for administering fluids, which includes characteristics to both control, and direct the angle of, fluid flow. Such an embodiment may be advantageous in light of the fact that premature infants and neonates are sensitive to rates of fluid flow. In the depicted embodiment, a receiving tube  160  is fixedly disposed within the interior of a nipple  134  and extends proximally to the nipple aperture  136 . When a cartridge  300  is not coupled to the receiving tube  160 , the plug  170  on the strap  180  may couple to the receiving tube  160  and block the inlet to the receiving tube  160 , allowing the nipple apparatus  130  to act as a soother while preventing air ingestion. The plug  170  of some embodiments is also configured to securely fit within a through-hole  103  within the distal face of the nipple base  132  when the receiving tube  160  is occupied. 
     In some embodiments of the nipple assembly  130 , for example, the nipple assembly  130  of  FIG. 23A  and  FIG. 23B , the receiving tube  160  is disposed within the nipple cavity  137  offset from a central axis  158 . The nipple aperture  136  is also offset from the central axis  158 . Advantageously, in such configurations, dispensed and/or ingested fluid exits the nipple aperture  136  offset from a central axis  158 , thereby minimizing unexpected direct expulsions of fluid into the mouth of a user, and thus, minimizing unwanted physiologic reactions such as choking and/or a gag reflex. Furthermore, such a configuration may be advantageous because hospital protocols for sucrose dispensing increasingly call for sucrose to be administered toward an infant&#39;s cheek or buccal surface. Additionally, some premature babies require a dextrose gel to be applied inside the infant&#39;s cheek to control hypoglycemia or low blood sugar levels. The disclosed embodiment may address these needs by allowing for fluid and/or gel delivery at a desired angle and orientation within an infant&#39;s oral cavity. In some embodiments, the nipple aperture  136  may be disposed on the proximal/bulbous end of the nipple offset from the central axis  158  of the nipple assembly  130  by 1° to 120°, for example, by 10°, 90°, or any value therebetween. In some such embodiments, the receiving tube  160  is laterally affixed to an inner side of the nipple wall  135 . In some embodiments, the receiving tube  160  is at least partially defined by an inner side of the nipple wall  135 . 
     In some embodiments, the nipple cavity  137  is hollow; in the alternative, to create a nipple assembly  130  having a greater density and/or improved structural integrity, some or all of the nipple cavity  137  may be filled with the same material that forms the nipple wall  135 . In some embodiments, a plurality of receiving tubes  160  are disposed within the nipple cavity  137 . 
       FIGS. 19A-19E  illustrate an example of one embodiment of a packaging unit for the pacifier apparatuses and/or nipple assemblies described herein. In the perspective view of  FIG. 19A , the packaging unit includes a shell  500  having a distal shell member  501 , a proximal shell member  502 , and an attachment element  503  configured to detachably connect the distal shell member  501  and the proximal shell member  502 . As shown in the exploded view of  FIG. 19B  and the perspective view of the proximal shell member provided in FIG.  19 C, the shell  500  of some embodiments has a plurality of anchor arms  506  extending from an inner surface of the shell  500  into an interior of the shell  500 . The plurality of anchor arms  506  are configured to secure any of the pacifier apparatuses described herein. Reference will be made to the pacifier apparatus  100  of  FIGS. 9A-9C  as a non-limiting example only. In some embodiments, the plurality of anchor arms  506  secure the pacifier apparatus  100  in a stable position inside the shell  500  by engaging with the one or more through-holes  103  located in the nipple base  132  or simply by holding the apparatus in a non-movable position, for example. Such a position of engagement is illustrated in the cross-sectional view of  FIG. 19E . In some embodiments, such as the one of  FIGS. 19A-19E , the attachment element  503  includes a pull seal  504  configured to wrap substantially around a circumference of the shell  500  and a pull tab  505  affixed to an end of the pull seal  504 . The pull seal  504  fixedly couples the distal shell member  501  to the proximal shell member  502  until the pull-tab  505  is pulled and the pull seal  504  is removed. The pull seal  504  of  FIGS. 19A and 19B  can be attached to a proximal end of the distal shell member  501  and a distal end of the proximal shell member  502 , for example, via a perforated connection. Alternatively, in some embodiments, the attachment element  503  and pull seal  505  are built into one or both of the distal or proximal shell member. In some embodiments, the distal shell member and proximal shell member each include a portion of the attachment element; for example, in some embodiments, each shell member has a ridge, groove, threading or the like, which couples one portion of the attachment element to the other portion of the attachment element  503 . In various embodiments, the attachment element  503  keeps the shell  500  hermetically sealed such that the sterility of the apparatus  100  is maintained until the seal is broken prior to use. The packaging unit may additionally include, for example, a double-sided adhesive pad  507 , as shown in  FIGS. 19B and 19C , or an anchor stub  508 , as shown in  FIG. 19E , positioned on an inner surface of the proximal shell member  502 . The adhesive pad  507 , anchor stub  508 , or other suitable sealant mechanism is provided for engagement with the nipple aperture  136 , for example, in order to prevent fluid from leaking out of the nipple aperture  136  of some embodiments prior to use. In some embodiments, the anchor stub  508  may additionally be used to pierce the nipple wall and initially create the nipple aperture  136  instead of making the nipple aperture  136  manufacture or assembly. In some embodiments, the anchor stub has a sharp, pointed, or jagged end. In other embodiments, it has a rounded or blunt end. The shell as depicted has a spherical or rounded shape. It should be understood that any other shape may be used and all suitable three-dimensional shapes are contemplated, for example, cubic, rectangular, pyramidal, oval, cylindrical, trapezoidal, etc. shapes. In some embodiments, the apparatuses, components (e.g., cartridges), etc. may be packaged in a paper, foil and/or plastic wrapper that can be cut or torn open, or that can be separated, for example, and then thrown away. In some embodiments, the items are vacuum packaged inside the outer wrapper. 
     In some embodiments, the pacifier apparatus  100  is either sterilized or manufactured under sterile conditions and then packaged into the above-described shell or other packaging unit before any fluid or cartridge is added to the apparatus  100 . In such embodiments, a healthcare provider, technician or caregiver, prior to use, would add fluid or attach the cartridge. In some embodiments, fluid or a fluid precursor is added to the cavity  137  of the apparatus  100  before the apparatus is sealed within a sterile packaging unit. In various embodiments containing fluid in the cavity  137 , the fluid has a desired or a known volume, composition, and concentration. In one particular embodiment, the fluid may include, for example, about 0.5 to about 4 mL (preferably about 2 mL) of a 24% USP sucrose solution. In other embodiments, different volumes, concentrations, and/or different fluids are provided. In some embodiments, the fluid includes, for example, a probiotic formula, a vitamin formula, a nutritive formula, breast milk, colostrum, sweetened water, an anti-gas solution, or a liquid medication. In order to extend the shelf life or portability of the system, the apparatus  100  of some embodiments is packaged so as to contain a fluid precursor. One such fluid-precursor is, for example, a liquid-filled gel capsule. In such an embodiment, a coating of the liquid-filled gel capsule may be configured to dissolve when subjected to a known environmental trigger in order to release the stored fluid into the cavity  137 . Such environmental triggers may include, without limitation, exposure to heat, exposure to light, injection of additional fluid into the cavity  127 , or physical pressure, for example. Another suitable fluid-precursor may be, for example, powder, such as a crystalline sucrose or a lyophilized solution. The powder within the cavity  127  can have a known amount and/or mass and may be configured to dissolve in water. In other embodiments, other fluid precursors may be used. 
     A plurality of packaging units, such as those described above, may be packaged together into a kit for shipping and/or sale. One embodiment of a kit is provided in  FIGS. 20A-20C . In such an embodiment, a plurality of shells  500  are stacked vertically and horizontally. The relatively spherical shape of each shell  500  allows them to be stacked into “egg” cartons, “egg” crates, or boxes. In another embodiment of a kit, a plurality of apparatuses  100  comprising nipple assemblies  130  of various sizes are packaged together. The nipple assemblies may differ in the size of their respective cavities  137 , the diameter of their respective nipples  134 , and/or the size of their respective nipple apertures  136 . Alternatively or additionally, the volume and/or concentration of fluid stored within the cavity  137  may vary across the plurality of apparatuses  100 . With such a configuration, the kits can be tailored to provide apparatuses  100  suitable for a spectrum of age groups. 
     The pacifier apparatus of various embodiments can be configured to couple, either directly or indirectly, to various accessories, making it a versatile tool for administering fluid or orally-administered medical instruments to young, infirmed, or disabled populations. For example, in some embodiments, the pacifier apparatus is configured to couple to a breast pump. In some such embodiments, the nipple cavity and the nipple aperture of the pacifier apparatus may be sized for receiving, storing, and dispensing colostrum and/or breast milk in amounts appropriate for neonates born at various gestational ages. Additionally, in some embodiments, the apparatus is configured to universally couple with various breast pump designs. In other embodiments, the apparatus can be configured to couple selectively with one or more breast pump designs, such as, for example, those manufactured by Ameda (e.g., Purely Yours®, Purely Yours Ultra™, etc.), Philips (e.g., AVENT), Bailey Medical (e.g., Nurture III), Evenflo (e.g., SimplyGo™) Hygeia (e.g., EnDeare™, EnJoye™, etc.), Medela (e.g., Pump In Style®, Freestyle®, Symphony®, Lactina®, Swing®, Harmony®, etc.), Simplisse®, or other manufacturer. Such breast pumps can include, for example, a breast shield or flange and a pumping mechanism and may optionally comprise a milk-storing container. The pumping mechanism may include, for example, a manual or electrical pump. 
     In some embodiments, a system for administering fluid includes, for example, a pacifier apparatus, such as, for example, any of the pacifier apparatus embodiments described previously herein, a breast pump as described in the preceding paragraph, and a connector or a means for connecting the breast pump directly or indirectly to at least a portion of the pacifier apparatus. In embodiments of the system having a direct connection between the breast pump and at least a portion of the pacifier apparatus, the connecting means can include, for example, a threaded connection, a fitted snap connection, or other suitable connection. In one such embodiment, the pacifier apparatus includes a nipple assembly and an insertable cartridge, such as, for example, the apparatus shown in  FIGS. 12A-12D . A proximal cartridge portion is configured to removably attach directly to the breast pump such that colostrum and/or breast milk can be dispensed and stored in the reservoir of the cartridge. In another embodiment, the breast pump may removably attach directly to a distal end of a nipple assembly. Such a nipple assembly may be configured to securely attach to a second portion of the pacifier apparatus, which includes a balloon, a rigid member, and/or a pump, once the nipple assembly is removed from the breast pump. 
     In embodiments having an indirect connection between the breast pump and at least a portion of the pacifier apparatus, the connector or connecting means may include, for example, tubing, piping, a funnel, a blunt tip needle, and/or another conduit for directing the flow of fluids from the breast pump to the pacifier apparatus. A first end of the connector, a connecting mechanism, or a connecting means can be configured to attach, at least indirectly, to an outlet of the pumping mechanism or to an outlet in the milk-storing container. In some embodiments of the system, a second end of the connector, a connecting mechanism, or a connecting means is removably attached to the pacifier apparatus at the site of the nipple aperture. Threading or another coupling element may be present to secure the connector, a connecting mechanism, or a connecting means within the nipple aperture. In some embodiments, such as the apparatus shown in  FIG. 22 , a connector or connecting mechanism may attach to the valve  182  and valve threading  184 . In balloon-less pacifier apparatus embodiments, such as, for example, those shown in  FIGS. 10A-10C and 11A-11C , the connector, the connecting mechanism, or the connecting means may alternatively attach to the pacifier apparatus at or within an opening in either the nipple base or the pump of the pacifier apparatus. 
     In another embodiment of the system, the nipple assembly  130  has complementary threading or other securement feature such as a snap or friction fit to couple the nipple assembly  130  to a syringe, such as, for example, a syringe from Acacia Neonatal® syringe line. In one non-limiting example, the nipple assembly  130  has securement features designed to couple the nipple assembly  130  to the NuTrio TwistLok™ enteral syringe. The threading or other securement feature of the nipple assembly  130  may be identical or substantially similar to the securement features of a bottle, jar, or other container of fluid such that the syringe can couple interchangeably to the container and the nipple assembly  130 . In some embodiments, the container is configured to hold 1 to 8 ounces of fluid. In some embodiments, the fluid in the container is a medication, such as an antibiotic, analgesic, numbing solution, or anti-gas solution (e.g., simethicone); in other embodiments, the fluid may be any fluid administered for the promotion of health, such as, a vitamins, probiotics, nutraceuticals, colostrum, breast milk, sugar solutions (e.g., sucrose), juices, electrolytes, vaccines, or nutritional supplements. In some embodiments, the nipple assembly  130 , the syringe, and the container may all be packaged as a kit. 
     Various embodiments of the pacifier apparatuses are configured to minimize the risk of choking. The pacifier apparatuses of some embodiments have no removable or loose parts. For example, in some embodiments, each pacifier apparatus is molded to have a unitary body design; in other embodiments, all components of the pacifier apparatus are permanently coupled to form a single unit. In some such embodiments, the diameter of the pacifier apparatus  100  at its widest location is at least 1.25 inches, and in some embodiments, the length of the apparatus  100  at its longest location is at least 2.25 inches. In other embodiments, each pacifier apparatus is formed of a separable nipple assembly and a separable cartridge. In some such embodiments, the length and diameter dimensions of the each removable part are selected so as not to pose a choke hazard to young children. For example, in some embodiments, the diameter of the nipple assembly  130  at its widest location is at least 1.25 inches, and the length of the nipple assembly  130  at its longest location is at least 2.25 inches. Similarly, in some embodiments, the diameter of the cartridge (for example, cartridge  200  or  300 ) at its widest location is at least 1.25 inches, and the length of the cartridge at its longest location is at least 2.25 inches. 
       FIG. 21  illustrates one embodiment of a method for manufacturing some of the apparatuses  100  disclosed above. In the embodiment, a nipple assembly  130  is molded such that it includes, for example: a nipple base  132  having a proximal face  133 , a distal face  131 , and a passage extending through the nipple base  132 ; and a nipple  134  extending proximally outward from the proximal face  133  and including a nipple wall  135 , which defines a cavity  137 . A nipple aperture  136  is formed through a proximal end of the nipple wall  135 . The nipple aperture  136  may be formed, for example, by making a slit in the nipple wall  135 , using a gauge needle or other apparatus to puncture a hole into the nipple wall  135 , or using any other suitable means. In some embodiments, a balloon  120  is inserted through the passage of the nipple base  132  and into the cavity  137 . In some such embodiments, at least a proximal end of a rigid member  112  is inserted into a distal mouth  122  of the balloon  120  such that the rigid member  112  may be fixedly coupled directly or indirectly to the passage wall upon insertion. In some embodiments, such as the embodiment of  FIG. 15 , the rigid member  112  may be tapered to facilitate insertion into the distal mouth  122  of the balloon  120 . Additionally, the cavity  137  is filled with a specified volume of liquid. 
     In another embodiment, the method of manufacturing a fluid apparatus, such as any of the apparatus  100  embodiments described above, includes, for example, positioning a distal mouth  122  of a balloon  120  around at least a proximal portion of a rigid member  112  such that an air passage exists between a body  124  of the balloon  120  and a hole  104  located on a distal portion of the rigid member  112  or on a pump  141  coupled to the distal portion of the rigid member  112 . The method also includes, for example, permanently affixing the distal mouth  122  to at least the proximal portion of the rigid member  112 , and vacating air from the air passage to retract the balloon  120  into an undeployed state. A nipple assembly  130  is formed, which includes a nipple base  132  and a nipple  134 . The nipple base  132  includes, for example, a proximal face  133 , a distal face  131 , and a passage extending through the nipple base  132 . The nipple  134  extends proximally outward from the proximal face  133  and comprises a nipple wall  135 , which defines a cavity  137 . The method further may include securely affixing the balloon mouth  122  and at least the proximal portion of the rigid member  112  to a wall  138  of the passage, forming a nipple aperture  136  through a proximal tip of the nipple wall  135 , and vacating air from the cavity  137 . Vacating air from the cavity  137  may include removing (e.g., vacuuming or sucking) air from the cavity  137  through the nipple aperture  136  or expelling air through the nipple aperture  136  by transitioning the balloon  120  into a fully deployed state, for example. At some stage of the method, the cavity  137  also may be filled with a desired volume of liquid. Filling the cavity  137  with a volume of liquid may include, for example, injecting the volume of liquid into the cavity  137  through the nipple aperture  136 . Alternatively, it may include any other suitable method of filling the cavity  137 , such as, for example, squeezing the pump  141 , inserting the nipple aperture  136  into a liquid, releasing the pump  141 , and removing the nipple aperture  136  from the liquid when a desired quantity of the liquid has entered the cavity  137 . The method may additionally include, for example, sealing the nipple aperture  136  and/or the hole  104  temporarily so as to prevent fluid from spilling from the cavity  137 . Any other method of manufacture, which successfully manufactures the apparatus  100  of various embodiments, may be used without departing from the teachings or spirit of the disclosure. 
     The various methods of manufacturing any of the above-described pacifier apparatuses may be tailored so as to create an age-specific and/or procedure-specific pacifier apparatus. In some embodiments, the apparatuses are designed to control the rate of ingestion of a liquid, such as a medicament or nutritional supplement. For example, before molding or otherwise forming the nipple assembly  130 , it may be advantageous to: determine an average number of sucks performed in a defined length of time by patients of a pre-defined age group; determine a desired length of fluid administration; determine a desired volume of fluid to be administered; calculate an optimum flow rate by dividing the desired volume by the desired length of fluid administration; calculate an optimum volume of fluid expelled per suck by dividing the optimum flow rate by the average number of sucks performed in a defined length of time; and select a desired nipple wall  135  thickness, a desired nipple wall  135  density, a desired cavity  137  volume, a desired nipple aperture  136  size, and/or a desired size of a distal cavity opening  104 , such that an apparatus  100  with these desired characteristics is configured to achieve a desired average pressure change within the cavity  137  during a suck and thereby achieve the optimum volume of fluid expelled per suck. The apparatus  100  can then be formed having the desirable age-specific and/or procedure-specific characteristics mentioned above. In one non-limiting example, a pacifier apparatus  100  is designed for the average infant. In some studies, the average infant sucks on a bottle between 50-90 times per minute, creating a negative pressure which induces liquid to flow from the bottle into the infant&#39;s mouth. With a bottle, the sucking pressure achieved by the average infant during nutritive sucking is −87.5±28.5 mm Hg. In some embodiments, it is optimal to create an apparatus that achieves similar pressure values. As described above, the pressure achieved within a pacifier apparatus  100  is dependent on a plurality of factors, including, for example, the material characteristics of the nipple wall  135 , the volume of the liquid, the diameter of the nipple aperture  136 , and where applicable, the diameter of the receiving tube  160 . In some embodiments, various characteristics of the apparatus  100 , including the diameter of the receiving tube  160 , are selected such that a pressure of −144.5 mm Hg to −30.5 mm Hg, and preferably, a pressure of −116 mm Hg to −59 mm Hg, or any sub-range or value therebetween is achieved, when the apparatus  100  is used by an individual sucking at an average rate and average force for an infant. 
     A method of manufacturing a nipple assembly  130  having a receiving tube  160  is also disclosed. The nipple assembly  130  may include some or all the features described elsewhere herein. In some embodiments, the shape of the nipple assembly  130 , complete with a receiving tube  160 , a nipple aperture  136 , and optionally a valve  182  and/or a plug  170  and strap  180  are formed as a single piece, for example, through molding or 3-D printing. In other embodiments, the nipple aperture  136  and/or the receiving tube  160  are added after the nipple and nipple base have formed. In some embodiments, the nipple aperture  136  includes, for example, one or more of a valve, a hole, a slit, and a frangible seal. The nipple aperture  136  may be manufactured with an open slit having a length between 0.005″ and 0.1″. In some embodiments, the slit may be oriented to help control the rate of fluid flow. For example, a slit may be molded in the nipple aperture  136  that is substantially parallel to the orientation of the user&#39;s mouth and lips. In another embodiment, the nipple aperture  136  slit may be perpendicular to the orientation of the user&#39;s mouth and lips. A slower fluid flow rate is achieved when the slit in the nipple aperture  136  is parallel to the user&#39;s mouth. In some embodiments, the proper directionality of the nipple assembly may be determined by the nipple base  132 . For example, the nipple base  132  may be visually marked to indicate proper orientation. In some embodiments, instructions on the nipple base  132  or the packaging indicate that the nipple aperture slit should be substantially parallel to a user&#39;s mouth to achieve a relatively slow flow rate and perpendicular to a user&#39;s mouth to achieve a faster flow rate. 
     In some embodiments, a method of administering medicine or fluid to a user includes removing or partially removing a cartridge seal  340  from a cartridge  300  to expose a cartridge spout  320 . The method further includes inserting the spout  320  into the receiving tube  160  of a nipple assembly  130 . To limit unintentional expulsion of the fluid, the cartridge  300  is held by the tab  350  and/or gripping portions  360  during insertion. The cartridge  300  may be twisted, snapped, or otherwise secured into place in the receiving tube  160 . The apparatus is placed into a user&#39;s mouth, optionally, with a specific orientation to achieve a particular strength of flow. The fluid may be expelled by sucking on the nipple  136  or actuating the cartridge body  310 . 
     As noted above, some embodiments relate to methods of using the apparatuses and systems described herein. For example, some embodiments relate to methods of providing comfort, alleviating pain, and/or treating an illness or medical condition. Examples of such situations include, without limitation, circumcision procedures, venipuncture, diagnostic procedures, upset stomach, gas, bowel movements, colds, flu, fever, and the like. The methods can include identifying a patient (e.g., an infant or neonate) and providing an apparatus as described herein to the patient where the device includes a desired fluid substance for the particular condition. For example, for a circumcision or venipuncture, the infant can be given the apparatus filled with a sugar solution, a pain medication (e.g., acetaminophen), etc. at a desired time prior to (e.g., 1-2 minutes prior to the procedure) or at the commencement of the procedure. If the infant is unable or unwilling to suck so as to receive a sufficient amount of the fluid, then the caregiver, doctor, or guardian can actuate the pump to assist in expelling an adequate amount, if the pump is included in the design. The methods can include the use of apparatuses with a measured volume of the particular solution according to the recommended dosage and/or duration of the procedure. The apparatus can be configured to expel a sufficient dosage of the solution over a desired period of time, such as the length of the pre-procedure time period, procedure time period, and/or any post-procedure time period. Examples of solutions include medications, such as antibiotics, analgesics, numbing solutions, anti-gas solutions (e.g., simethicone), vitamins and minerals, colostrum, breast milk, sugar solutions (e.g., sucrose), juices, electrolytes, vaccines, nutrient formulas, etc. 
     The foregoing description details certain embodiments of the systems, devices, and methods disclosed herein. It will be appreciated, however, that no matter how detailed the foregoing appears in text, the devices and methods can be practiced in many ways. As is also stated above, it should be noted that the use of particular terminology when describing certain features or aspects of the invention should not be taken to imply that the terminology is being re-defined herein to be restricted to including any specific characteristics of the features or aspects of the technology with which that terminology is associated. The scope of the disclosure should therefore be construed in accordance with the appended claims and any equivalents thereof. 
     It will be appreciated by those skilled in the art that various modifications and changes may be made without departing from the scope of the described technology. Such modifications and changes are intended to fall within the scope of the embodiments, as defined by the appended claims. It will also be appreciated by those of skill in the art that parts included in one embodiment are interchangeable with other embodiments; one or more parts from a depicted embodiment can be included with other depicted embodiments in any combination. For example, any of the various components described herein and/or depicted in the Figures may be combined, interchanged or excluded from other embodiments. 
     With respect to the use of any plural and/or singular terms herein, those having skill in the art can translate from the plural to the singular and/or from the singular to the plural as is appropriate to the context and/or application. The various singular/plural permutations may be expressly set forth herein for sake of clarity. 
     It will be understood by those within the art that, in general, terms used herein, and especially in the appended claims are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the terms “comprising” and “having” should, respectively, be interpreted as “comprising at least” and “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to embodiments containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an.” In general, “a” and/or “an” should be interpreted to mean “at least one” or “one or more”; the same holds true for the use of definite articles used to introduce claim recitations. Furthermore, in those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general, such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that virtually any disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms. For example, the phrase “A or B” will be understood to include the possibilities of “A” or “B” or “A and B.” 
     Although the technology has been described with reference to embodiments and examples, it should be understood that numerous and various modifications can be made without departing from the spirit of the invention. Accordingly, the technology is limited only by the following claims.