There has been a debate about whether nipple confusion in breastfeeding (sometimes also called nipple-teat confusion) exists or whether it is a myth. In reality, evidence and our experience in supporting thousands of breastfeeding mothers show that there are all types of babies: those who can suckle from a bottle teat, a pacifier and at the mother’s breast interchangeably without any problems, and other babies who are given one single feed from a bottle and seem to no longer know how to or want to breastfeed.

There are two main challenges with bottle feeding and nipple confusion, and they are related as much to the bottle’s content as to the way of feeding. Firstly, the teat of a baby bottle, no matter how much anyone will try to sell you and claim it is similar, is not and will never be anything close to breasts at all. Nipple confusion exists because breastfeeding and sucking from a bottle teat require very different movements of the tongue and the muscles of your baby’s mouth. Secondly, the amount of milk a baby usually receives from a bottle is much more than the amount they will get from breastfeeding. Consider also the time factor because any baby will get milk out of a bottle quicker than from the mother’s breasts: no wonder the baby gets frustrated.

Some babies seem to have more ability to suck on anything without problems, while others seem lost and confused at the breast after just one or two bottle feeds.

What exactly do babies with nipple teat confusion do?

Usually, a nipple-teat-confused baby is restless at the breast and can even reject breastfeeding altogether. Some babies even refuse to be put into a breastfeeding position by crying and putting their hands in front of the breast.

They tend to start showing some problems when latching on, have difficulties finding the breast and start to move their mouth from one side to the other over the nipple, it seems that it is difficult for them to latch on.

When they do latch on, they are nervous, make noises and move around a lot at the breast, they just don’t seem to relax and pull by the nipple nervously.

If the confusion progresses, babies don’t want to breastfeed anymore at all and react almost aggressively when they are approached to the breast. At this point, any mother will get desperate, as the baby makes it very clear that they no longer want to breastfeed.

Is it easier for babies to drink from a bottle?

It might seem easier, but for a baby, it is not easier to feed from a bottle than from the breast.

The sucking motions a baby makes at the breast are much more natural and allow your baby to control swallowing and breathing much better, making it a much less stressful experience.

When babies drink from the bottle, they must put their tongues out more to stop the flow of milk falling on them and avoid choking.

It’s not easier or more difficult, it’s just totally different. The movements they make to get milk from the breast are very complex, and babies can simply “unlearn” how to do it.

Also, receiving large amounts of formula milk in a very short and convenient time makes the breastfeeding experience frustrating and annoying for babies because it requires a lot more time and patience for them.

How can I fix it now and get my baby to breastfeed happily again?

Each baby and mother are unique, so each situation needs to be considered individually. If the confusion is at the beginning and you’ve only recently started introducing bottles, it’s wise to remove them. This means replacing the bottle as a method of offering milk, but don’t eliminate the amount of expressed breastmilk or formula milk given. If the baby needs this amount or you have opted for mixed feeding, a feeding session cannot be removed altogether. The idea is to offer pumped breastmilk/formula in something other than a bottle to reduce confusion as much as possible.

You can use different methods of supplementing (find more information in our breastfeeding app) and see which one works best for you. A good way to do this is by using the syringe-finger technique, which helps your baby to place the tongue in a position similar to the one used for breastfeeding. This is a good way to help get your baby to return to breastfeeding.

Another essential thing to do is not to force the baby to breastfeed: your breast has to be an option, not an obligation. Being close to your baby in skin-to-skin contact is very positive, but when you place your baby close to you, avoid nudging and “inviting” them to breastfeed; they must be the ones who make the step in looking for the breast and want to feed from your breast again.

Another idea is to try to co-sleep together at night with fewer clothes on if you wish (please check out information on safe co-sleeping), this continuous contact can help your baby to rediscover the natural source of breastmilk again.

Does your baby latch on well, but it seems to start fuzzing after a while?

This situation is also quite common; the baby starts feeding relaxed and becomes uncomfortable after a while. This happens because it gets full faster at the bottle than at your breast.

The fact that your baby wants to breastfeed is very positive, so you can take advantage of it and help make it easier for them.

The first technique to try here is the breast compression method, which makes it easier and a little faster for your breast milk to come out of the breast, and your baby will not get upset.

Another technique you can try is to use a supplemental nursing system so the milk flow is more constant and your baby does not lose interest in breastfeeding.

How long will it take?

This is perhaps the most challenging question to answer. It may not be easy; it may take weeks or months to reverse the entire process.

It is a process of hard work as it requires time and a lot of motivation. No one can say how long it will take for your baby to learn and get interested in breastfeeding again, and no one knows if you are going to get tired from trying.

What if I don’t manage to get my baby back to breastfeeding?

It’s something that can happen: no matter a mother’s effort, babies who experience nipple confusion don’t always get back to breastfeeding again. And when you try, you have to remember that you are giving it a try, but you might not always be successful.

If you are looking for more support:

You can find our IBCLC lactation consultants in the Consultation Channel of the LactApp app, which is free to download for iPhone and Android.