What is nipple confusion?
When breastfed babies are given an artificial nipple to drink
from, they might become confused and not know how to drink from the
breast. These two feeding methods entail completely different tongue and
mouth movements and swallowing skills.
During breastfeeding a baby uses his jaw and lips to pump and grip
the nipple and breast for effective breast drainage. The suction needed
during breastfeeding actually helps for oral development in babies.
Not all babies will develop nipple confusion, some babies have no
problem going back and forth between the bottle and the breast. It also
usually only occurs in the first few weeks of a baby’s life.
What Causes Nipple confusion?
When a baby breastfeeds, he/she can regulate the amount of milk flowing
from the breast, but a bottle flows more rapidly. If Baby has been
exclusively or partially bottle-fed and then expected to breastfeed, he/she might refuse to take the breast. This is sometimes called a "nipple
A mother might introduce the artificial nipple too early and
then Baby might not want to drink from the breast anymore, because drinking
from the bottle is so much easier.
The best thing to do is to keep your baby
exclusively on the breast before introducing an artificial nipple for
the first 6 weeks, this will get your own milk supply established and
also give your baby time to learn.
Signs of Nipple Confusion
- Baby thrusts his/her tongue upward during sucking and pushes the breast out of the mouth.
- Baby doesn’t open he's/her mouth wide enough and therefore only sucks the tip of the nipple, which can cause nipple pain.
- Baby becomes fussy and irritable because milk does not flow as easily as with a bottle.
- Moms milk supply often decreases because Baby does not latch on correctly.
- Baby refuses the breast completely.
How to Prevent Nipple Confusion
- Avoid bottles the first 6 weeks.
- Avoid using a pacifier.
- Use an artificial nipple that flows slowly.
- Never force a baby to breastfeed, gently encourage your baby to accept. Praise and encourage your baby when he/she succeeds.
- Make it clear to the nurses (even with a special notice on your baby's crib) and doctors at the hospital, that you do not want your baby given a bottle. Sometimes the nurses will feed a baby at night while you sleep, thinking they are helping, but actually doing more harm than good. Keep your baby in your room, so that you can breastfeed on demand.
How to Cope with Nipple Confusion
- Breastfeed your baby when he/she is calm.
Read more about how to calm a baby for breastfeeding.
- Moms that want to breastfeed a nipple confused baby, will need
to pump milk a few minutes before feeding their baby, so that
their milk ejection reflex is stimulated; this is so that their baby does not have to
wait for the milk to start flowing.
- If it is impossible for you to breastfeed your baby within the first few weeks, you can use
alternative feeding methods,
like syringe and
or “finger feeding”. This is so that your baby is not introduced too early to an artificial nipple.
- Keep your baby close to you, with skin to skin contact while trying to breastfeed.
- If your baby refuses your breast altogether, remember that you can
still pump and continue to feed your baby breast milk. Using a double action,
electric pump is best to keep your milk supply up.
Read more about how to choose the best pump for you.
- Keep your baby close to your uncovered breast during the night and even the day with a sling (kangaroo nursing) if possible.
Read more about breastfeeding in a sling.
When Introducing a Bottle to a Breastfed Baby
What about bottle feeding problems “Bottle confusion”?
Baby won't take a bottle?
Sometimes a baby refuses bottle, when he/she has been breastfed exclusively. Getting your baby to take a bottle, may be frustrating; especially when a mother is returning to work.
- Sometimes a baby won't take a bottle because of the heavy flow of an artificial teat. Most times, all you need to do is give Baby a bottle that has a slow flowing teat.
- If your baby won't take bottle fed formula, you can always try pumping your breast milk for at least the first month, to get Baby to accept the bottle.
- The best thing to do, if you would really like your baby to drink from an artificial nipple, is to introduce it early enough (after 6 weeks) so that your baby can get familiar with both the breast and artificial nipple. This is helpful, if mom is thinking of returning to work after a few months.
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Site by BFeeding Mamma, Tracy Behr, Studying through Child birth international (CBC, CBD), Author and Mommy of two.