Nipple Confusion, a.k.a Nipple Preference

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 entirely different tongue and mouth movements and swallowing skills.

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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 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 adequate breast drainage. The suction during breastfeeding promotes oral development in babies.

Not all babies will develop nipple confusion, and some babies have no problem going back and forth between the bottle and the breast. It commonly occurs during the first few weeks of a baby’s life.

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What Causes Nipple confusion?

When a baby breastfeeds, they can regulate the amount of milk flowing from the breast, but a bottle flows more rapidly. If the baby has been exclusively or partially bottle-fed and then expected to breastfeed, they might refuse to take the breast. This is sometimes called a 'nipple strike.'

A mother might introduce the artificial nipple too early, and then the baby might not want to drink from the breast anymore because drinking from the bottle is much easier.

The best thing to do is to keep your baby exclusively on the breast before introducing an artificial nipple for the first six weeks; this will establish your own milk supply and allow your baby some time to learn to breastfeed.

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Signs of Nipple Confusion

  • The baby thrusts their tongue upward during sucking and pushes the breast out of the mouth.
  • The baby doesn’t open their mouth wide enough and only sucks the tip of the nipple, which can cause nipple pain.
  • The baby becomes fussy and irritable because milk does not flow as easily as in a bottle.
  • The mother's milk supply often decreases because her baby does not latch on correctly.
  • The baby may refuse the breast altogether.

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How to Prevent Nipple Confusion

  • Avoid bottles for the first six weeks.
  • Avoid using a pacifier.
  • Use an artificial nipple that flows slowly. Best breast milk bottles discussed here.
  • Never force a baby to breastfeed; gently encourage your baby to accept. Praise your baby when they succeed.
  • Make it clear to the nurses and doctors at the hospital that you do not want them to give your baby a bottle. Sometimes the nurses will feed a baby at night while you sleep, thinking they are helping but 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 they are calm.
  • Mothers 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 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 cup feeding or finger feeding. This is so your baby is not introduced to an artificial nipple too early.
  • 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.
  • Keep your baby close to your bare breast at night and even during the day with a sling if possible. Learn more about Kangaroo mother care here.

When Introducing a Bottle to a Breastfed Baby

What about bottle feeding problems, 'Bottle confusion'?

  • This refers to when a baby refuses bottle feeding after they have been breastfed exclusively. Getting your baby to take a bottle may be frustrating, especially when a mother returns 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 your baby a bottle that has a slow-flowing teat.
  • The best thing to do if you would like your baby to drink from an artificial nipple is to introduce it early enough (after six weeks) so that your baby can get familiar with both the breast and artificial nipple. This is helpful if the mother considers returning to work after a few months.

When Should You Introduce a Bottle?