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Is Nipple Confusion Real?

Many moms who choose to breastfeed often wonder “is nipple confusion real”. We have all heard conflicting information, some say yes it is real, while others say absolutely not. If you decide to breastfeed you can’t go forever without introducing a bottle just in an attempt to avoid nipple confusion.

Is nipple confusion real then?

Is nipple confusion real

I think the answer to this is more of an opinion than a fact and depends on who you ask.

From my own experience with breastfeeding I say that yes, nipple confusion is real. Once my daughter had a bottle, she would not latch back on to the breast, not matter how hard I tried. Sucking formula or breastmilk from a bottle takes a lot less work than taking it from the breast, so once my daughter learned it was easier, she didn’t want to work for her food any more. I even used bottle nipple that were meant for easy transition from breast to bottle and back.

Other moms will tell you they had no problems and that nipple confusion is not real. I have heard of moms who start their babies with bottles after just a couple of weeks and their baby switches with ease.

Even if you ask doctors, you will get different opinions.

For example, where I work, most doctors will not suggest that a breastfeeding mom supplement her baby with formula unless the baby is not gaining weight, and that is usually only after breastfeeding has been well established because they know the benefits of breastmilk outweigh the benefits of supplementing and risking nipple confusion.

There are a couple of doctors that will suggest a mom supplement with formula if the baby is jaundiced, especially if they don’t think the moms milk is in. Their thought is that if the baby is getting any milk from mom than she will latch on even if she has had a bottle.

In the end, nipple confusion is real, but there is no way to tell which babies will be affected by nipple confusion and which ones won’t be. Some babies can start on a bottle or pacifier after just a week with no problems, while others will have issues even after several months.

Can I help prevent nipple confusion?

Breastfeeding is tough, and to have all that hard work undone because your baby gets confused is devastating. There are steps you can take to help prevent nipple confusion though.

  • Wait until breastfeeding is well established to introduce a bottle. Waiting a few weeks before introducing a bottle will help ensure that your baby knows how to breastfeed and that you know how to help your baby breastfeed.
  • Have someone else give the bottles. Your baby associates you and your smell with breastfeeding. Having someone else give the bottles will help keep your baby from associating you and your smell with a bottle. This is a great time for dad to feed the baby since he hasn’t had a chance to yet. This is not saying you will never be able to give your baby a bottle, but you want to start with someone else giving the bottles.
  • Give breastmilk in the bottles if possible. If you are able to pump enough breastmilk, give breastmilk in the bottles because your baby will recognize the smell. You can make sure you keep up your supply by regularly breastfeeding and/or pumping.
  • Decide the right time to give baby her first bottle. You don’t want to wait until your baby is starving and crying to eat for her first bottle. If you wait until she is starving she may get frustrated because the bottle is unfamiliar.
  • Try skin to skin contact. Skin to skin contact has been shown to help calm a baby and regulate heart rate. If your baby is having trouble taking the bottle, try skin to skin contact. It may help her to calm down. The closeness may also make her feel secure like she does when she is breastfeeding
  • Stay calm. Babies can sense anxiety and if you are anxious about giving her a bottle, she will sense it. If you are anxious about the bottle, step out of the room while someone else gives her the bottle. Make sure whoever is giving her the bottle is calm and makes drinking from a bottle a pleasant experience.
  • Practice, practice, practice. Don’t wait until the day you go back to work to give your baby a bottle for the first time. If for some reason your baby won’t take the bottle there is no alternative way to feed her while you are away. The first time you give her a bottle you can walk out of the house but stay close. If she takes the bottle great, if she doesn’t try again later. If she is starving, the breastfeed and try the bottle again later. It may take a lot of practice before your baby takes a bottle.
  • Get help. If you notice that your baby is starting to prefer the bottle over the breast, especially when you are the only one around, get help from a lactation consultant. During this time make sure you continue to pump so you can keep your supply up.
  • Breastfeed regularly. Just because you introduce the bottle doesn’t mean you have to use the bottle all the time. If you are close to your baby make sure you continue to breastfeed. If you go a couple of days without a breastfeeding session your baby may start to reject the breast and prefer the bottle. Try to have at least one time every day that your baby is breastfed and never bottle fed, for example maybe the first feeding in the morning or the last one before bed.
  • Your premie may still breastfeed. Don’t worry about your premie getting bottles. Often times their suck mechanism is not fully developed and by the time they reach their due date they may be able to breastfeed. Make sure you are pumping while your baby is in the NICU and consult a lactation consultant when you want to start to try breastfeeding. Even if your baby doesn’t breastfeed you can still pump and give breast milk.
  • Use a bottle designed for breastfed babies. There are bottles made for breastfed babies where the nipple mimics the breast to make it easier for babies to switch between bottle and breast.
  • Try different bottles. There are so many different types of bottles and nipples. It may take some trial and error and you may have to try several different types of bottles before you find one your baby will take.
  • Use slow flow or newborn nipples. This will slow the flow making baby have to continue to work harder for food. When breastfeeding a baby doesn’t get instant gratification, she has to work to get the breasts to let-down the milk, using a slow flow nipple will ensure baby actually has to suck to get the milk instead of it just dripping in her mouth.

Nipple confusion is real, but since there is no way to know which babies will be affected by it and which babies won’t it is best to do everything you can to avoid it in the first place.

Did you have any issues with nipple confusion? Did you do anything to help avoid nipple confusion? If you had issues with nipple confusion, what did you do?

Thanks for reading, Cassie

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