How to Avoid Nipple Confusion for the Breastfed Baby
If a breastfed baby is given a bottle during the first few weeks while he is still learning how to breastfeed, “nipple confusion” can occur. A nipple-confused baby may have difficulty latching or may try to use a bottle-feeding type of suck on the breast. The type of suck used for bottle-feeding will not be effective in getting milk from the breast and may irritate mom’s nipples.
Differences in the way a baby sucks on the breast vs. a bottle
- To latch to the breast, baby must open his mouth widely. A baby does not need to open wide to suck on a bottle.
- When sucking on the breast, baby’s tongue makes a wave-like motion; it begins at the tip of the tongue and moves toward the back. The tongue compresses the breast against the roof of the mouth. A bottle fed baby uses his tongue differently and may lift the back of his tongue to stop the flow of milk and protect his airway.
- If a breastfed baby needs a rest, he simply quits sucking and the milk flow slows. Milk may flow from a bottle even when baby is not sucking, forcing baby to continue feeding without a break.
Signs of nipple confusion
- The following is a classic sign of nipple confusion: Baby’s open mouth is near the breast but he moves his head back and forth as though he is unable to find the nipple. The baby is looking for something longer and firmer than the mother’s nipple.
- This can be very frustrating for both mom and baby!
Helping a ‘nipple confused’ baby return to the breast
- Snuggle baby skin to skin (baby in just a diaper against your bare skin.) This helps to calm baby and tap into to his natural instincts.
- Make a ‘ledge’ or ‘sandwich’ of breast tissue when latching. This can help baby to feel something firm against his tongue.
- Attempt when baby is calm. If he is particularly hungry and frustrated, you may need to feed him a bit from a dropper, spoon or bottle to calm him before reattempting.
- In some difficult cases, a nipple shield may used to help coax baby back to the breast.
If you are struggling, consult with an International Board Certified Lactation Consultant or someone skilled in helping women with breastfeeding.
How to prevent nipple confusion
Every baby is different. Some babies develop nipple confusion after one bottle. Others may develop it after several bottles. Still others may go back and forth from bottle to breast with little difficulty.
- Avoid all artificial nipples for the first 3 to 6 weeks. This gives baby time to practice proper breastfeeding sucking patterns.
- If and when you do introduce a bottle, choose a slow flow nipple. Babies can become hooked on the fast flow of bottles and may become frustrated when the milk flow from the breast is not as rapid. Different brands use different words to refer to their slowest flow nipples: ‘slow flow’, ‘0+months’, ‘newborn’ etc. There is no research to suggest that any one brand is best. (Some have very clever marketing information on their packaging. Beware! Just because a brand claims to be ‘most like mother’ or ‘best for breastfed babies’ does not mean it is!) For more information on choosing a bottle and nipple, see this excellent post by The Leaky Boob.
- Be sure to coax baby to open wide before putting the bottle in his mouth.
If at all possible, try not to use a bottle every day. Offering a bottle every day may lead to decreased milk supply.
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Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.
- Download their FREE ebook: 5 Crucial Ways to Prepare for Breastfeeding.
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