There has been a debate whether nipple confusion (or sometimes called nipple-teat confusion) exists or whether it is a myth. In reality, evidence and our experience in supporting thousands of breastfeeding mothers shows, there are all types of babies: those who can suck a teat, a pacifier/dummie 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 or want to breastfeed.
There are two main challenges with bottle feeding and they are related as much to the content of the bottle as for 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 a breast at all. Breastfeeding and sucking a nipple requires very different movements of both the tongue and the muscles of your baby’s mouth. Secondly, the amount of milk that a baby usually receives from a bottle is much more than the amount she will get from breastfeeding. Consider also the time factor, any baby will get milk out of a bottle quicker then from her mother’s breast: 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 does a baby with nipple-teat confusion exactly do?
Usually a nipple-teat confused baby is restless at the breast and can even reject breastfeeding completely. 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 to find the breast and they move their mouth from one side to the other over the nipple, it seems that it is difficult for them to start breastfeeding.
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 at all 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 she no longer wants to breastfeed.
So is it easier for my baby to drink from a bottle?
It might seem easier, but for a baby it is not easier to to feed from a bottle then from the breast.
The sucking motions a baby makes on the breast is much more natural and allows your baby to control swallowing and breathing much better, making it a much less stressful experience.
When babies drinks from the bottle, they have to put their tongues out more, to stop the flow of milk that falls 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 just simply “unlearn” how to do it.
Also, receiving large amounts of formula in a very short and convenient time, makes the breastfeeding experience frustrating and annoying for a baby, because it requires a lot of time and patience.
How can I fix it now and get my baby happy at the breast again?
Each case of baby and mother is unique, so we need to evalutate each particular situation. If the confusion is at it’s beginning and you’ve only just recently started to introduce bottles, it’s wise to remove them. This means replacing the bottle as a method of offering milk, not eliminating the amount of expressed breastmilk or formula milk given, because if the baby needs this amount or you have opted for a mixed feeding method, a feeding session cannot be removed all together. The idea is to offer breastmilk/formula in something other than a bottle in order to try to reduce confusion as much as possible.
You can use different methods of supplementation (find more information in our breastfeeding app) and see which one works best for you. A good way is the syringe-finger technique that helps your baby to place the tongue in a position similar to the one of breastfeeding. This is a good way, to help getting the baby to return to your breast.
Another important thing to do, is not to force the baby to breastfeed: your breast needs 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” her to breastfeed, she must be the one who makes 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 few cloths on if you wish (please check out information on safe co-sleeping, for example in our app LactApp), this continuous contact can help your baby to rediscover the natural source of breastmilk again.
Does your baby latch on well, but then seems to start fuzzing after a while?
This situation is also quite common, the baby starts to feed 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 it is very positive, so you can take advantage of it and help make it easier for her or him.
The first technique to try is the breast compression method, which makes it easier and a little faster for your milk to come out of the breast and your baby will not get upset.
Another technique you can try, is to use a relactor, a supplemental nursing system, so the milk flow is more constant and your baby does not lose interest in breastfeeding (more information in the LactApp app).
How long will it take?
This is perhaps the most complicated question to answer. It may not be easy at all, 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 can say how long it will take for your baby to learn and get interested into 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 feeding from my breast?
It’s something that can happen: no matter a mother’s effort, babies who experience nipple confusion don’t always get back to breastfeed again. And when you try, you have to keep in mind that you are giving it a try, but you might not always be successful.
(Alba Padró is Head Expert Lactation Consultant/IBCLC at LactApp, translated by LactApp UK team). For more information download the LactApp app and get personalised answers to your breastfeeding questions.