Nipple confusion can occur if a baby is offered artificial nipples before or soon after starting to breastfeed. It is much harder to get milk from a breast than from a bottle. When breastfeeding, baby must open her mouth very wide and use her jaw muscles and her tongue to draw milk from the breast. She also usually has to wait a little for let-down to occur. With bottle feeding, there is only the relatively narrow nipple, so she does not have to open her mouth wide. Instead of working to get the milk, it flows continuously, and there is no waiting for let-down. A baby who is offered an artificial nipple too soon may have difficulty breastfeeding or may even refuse the breast altogether. An Ounce of Prevention… Nipple confusion typically occurs within the first few weeks of baby’s life. That is why it is best to make sure you baby does not receive any artificial nipples, including pacifiers, for the first month or so. During this time, your baby is perfecting her breastfeeding technique. Once baby has mastered breastfeeding, artificial nipples can probably be introduced without problems. Patience and Persistence Nipple confusion does NOT have to mean the end of breastfeeding. You can reteach baby to nurse, but it may take some time. First, get rid of all artificial nipples, including pacifiers. If you need supplemental feedings, use a spoon, cup, eyedropper or feeding syringe. Breastfeed when baby isn’t too hungry and is in a calm mood. Express a little milk first so that baby can smell and taste what she will be working for. Expressing also has the benefit of encouraging let-down. Make sure that baby is latching on correctly. Finally, remember to praise and encourage your baby as she relearns to nurse. Reteaching baby to breastfeed can be frustrating and it may take several days. If you are worried baby isn’t getting enough milk, or are feeling ready to give up, try meeting with a lactation consultant. She may be able to give you just the one-on-one support that you need!
