Breastfeeding - Nipple Confusion

• In many hospitals, they will give your baby formula or glucose water from a bottle during your hospital stay.
  • Some do this to see if the baby is able to suck properly. This is unnecessary; you can do this by putting the baby at your breast.
  • At other hospitals, you are expected to leave your baby at the nursery, and they bottle-feed the baby there.
  • They might to this because it's easier for them: they just feed all the babies on a certain schedule instead of bringing your baby to you when she or he is hungry.
  • They'll often do it at night because they think it's a favor to you to let you sleep.
• Drinking from a bottle is very different from suckling at the breast.
  • To suckle at the breast, the baby needs to open her or his mouth wide, pull the nipple far into her or his mouth, flange her or his lips out, use the lower jaw and the tongue to pull back on the areola to draw milk from the reservoirs.
  • Bottle nipples are stiff, and they are designed to drip by themselves.
  • A baby does not need to apply any suction to keep a stiff bottle nipple in place.
  • The tongue is used to push on the bottle nipple to stop the flow when necessary.
  • It is not necessary to draw the bottle nipple far back into the mouth. It will work wherever it is.
• Newborn babies often cannot handle learning to suckling techniques at once. Babies who are given bottles will often not know what to do with the breast and push the nipple out with their tongue.
• It is easier to get milk from a bottle. It takes some work to get milk from a breast. Many babies who have been given bottles will get frustrated at the breast.
• New mothers often think this is because they don't have enough milk. The real reason is that the baby is confused. She or he expects the breast to work like a bottle.
• Pacifiers can cause nipple confusion too. It's best to avoid pacifiers and bottles for a few weeks, until your milk supply is well established and your baby knows how to latch on correctly.
• Using supplementary bottles or pacifiers in the early stages of breastfeeding can cause milk supply problems too, since it decreases the amount of stimulation your breasts get.

What to do to avoid nipple confusion?

• If the hospital has a policy of giving glucose (sugar) to babies to see if they can swallow properly, ask that they do it with a syringe or spoon instead of a bottle.
• At the hospital, room in with your baby. This way, you'll be able to breastfeed exclusively and on demand.
• It's best if you can have a private room and your mate or someone else can stay with you.
• If your baby has to go to the nursery, tell everyone that you want your baby brought to you whenever she or he cries during the day or during the night.
• Have your labor companion tell everyone too. Hospital staff may assume that a new mother is being irrational due to fatigue or medication. If your labor companion tells them the same thing, they might be more impressed. It's best to start telling everyone as soon as you check in (before your baby is born).
• Tape a piece of paper on your baby's crib with the following message in big letters:

   

  	NO BOTTLES NO PACIFIERS
  I am a breastfed baby, bring me to my mom every time I cry, during the day or night Room number: ...

  This may look silly or even ridiculous to you, but do it! The hospital staff will be overworked and they might have a hard time remembering which baby is supposed to be bottle-fed at night, which one is supposed to be brought to mom on a schedule, and which one on cue.

• If the hospital won't let you keep your baby in your room, and there are no medical problems that require you or the baby to stay in the hospital, consider checking out early and going home.
  • Even if you follow all the recommendations above, unfortunately you cannot be sure that your baby won't be given a bottle.
  • The point of the hospital stay is to help you and your baby. Jeopardizing your breastfeeding relationship is not helping either of you. You're better off at home.
  • You might also consider home birth if your hospital is not baby-friendly.

How to deal with nipple confusion?

• Even if you try everything, your baby might end up getting bottle-feeds and pacifiers in hospital. What to do then?
• First, relax. Many babies will nurse just fine even if they've had lots of bottles and pacifiers. Those who do have nipple confusion can usually be coaxed back into nursing in a day or two.
• See the page on latching on. Try to follow all the recommendations there.
• Many babies will get frustrated at the breast because the milk doesn't start to flow immediately. You can alleviate this by beginning to express your milk. Latch your baby on as soon as you get a few drops of milk from your nipple.
• If your baby continues refusing the breast after half a day or so, start expressing and pumping milk to feed your baby. This way, you'll be able to keep your milk supply up until your baby starts nursing again.
• Try nursing your baby when she or he is not particularly hungry. She or he might have more patience and continue sucking until your milk lets down. You can try to nurse your baby when she or he is sleepy, too. See the page on nursing a fussy baby.
• Sleep your baby with your breasts uncovered. Keep your baby's face close to your chest. Your baby can smell you and even your milk, and this may establish good bonding that will lead to successful nursing. During the day, too, hold your baby on your lap with her face close to your bare chest.
• If you have to supplement nursing (with expressed breastmilk or formula), use a cup, spoon, or syringe. Put the milk just at your baby's lips and let her or him do the rest of the work. If you use a bottle instead, you'll be making the nipple confusion worse.
• Call a lactation consultant if the problem persists more than a day or two.

Go to:

• Breastfeeding problems and solutions

Back to the breastfeeding main page

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