Nipple Confusion in Babies

Nipple confusion in babies is not uncommon, and it happens when a baby struggles to get adjusted to sucking from nipples after having learnt how to suck on a bottle or a dummy.

For a baby, sucking on the nipples or the sucking that is needed for breastfeeding is different from sucking on a teat or dummy. This means that your baby finds it difficult to latch on (hold on) to your breasts and suck milk. This causes confusion. However, it isn’t something that should alarm the mother since there are ways to resolve it.

Video: Nipple Confusion in Babies

What Is Nipple Confusion?

In most bottles, the teats are rigid, and the flow of milk is also constant. This means your baby does not need to work much in order to get the milk.

On the other hand, when it comes to feeding on your breast, your baby needs to open his mouth to latch on. Along with it, he also needs to use around 40 muscles in his mouth to suck the milk.

Nipple confusion arises when a baby finds it difficult to switch between a bottle and a breast. There are multiple reasons why some babies don’t learn how to breastfeed right from day one. One of the main reasons is that they find it difficult to latch on. However, that should not disappoint you. If your baby is not able to latch on and is reluctant to breastfeed, this does not mean that your baby is rejecting the breast milk.

My Baby Is Not Drinking Breast Milk But Prefers a Bottle – What Should I Do?

The first thing that you need to find out is why your baby is giving the teats of the bottles more preference when naturally, he should prefer your nipples. You can also consult a lactation expert and seek help with the best latching positions to help your baby breastfeed.

Till your baby gets comfortable with latching, you can try to find a way to feed him breast milk that is poured into a bottle instead of from the nipple. This way, your baby will get the breast milk.

Does a Breastfed Baby Get Confused With a Bottle of Expressed Milk?

Yes, a breastfed baby may get confused with expressed breast milk, too. In fact, nipple confusion can happen whenever there is a fast flow of milk, as babies prefer the fast flow of milk. It is estimated that giving your baby milk in bottles can lead to breastfeeding issues. However, it is hard to say whether the bottles are the cause of the problem or if there are other existing breastfeeding problems that force mothers to try bottled milk.

While trying to establish breastfeeding, you can consider introducing a bottle of expressed milk. Feeding expressed milk ensures your baby gets all the benefits of breastmilk while allowing you the luxury of delegating the job of feeding. Try out different bottles and see which one your child responds to best to figure out the best bottle to avoid nipple confusion. 

When expressing, keep in mind your baby’s 24-hour feeding routine. Your breasts will be able to produce the same amount of milk every day, and you will not have the feeling of becoming uncomfortably full (breast engorgement).

What Are the Causes of Nipple Preference?

As a general rule, all babies are born with the knowledge of how to suck, and their brains are hardwired to suck from their mother’s breasts. However, at times, they develop a preference for the teat of a bottle and find it difficult to suck from the breasts, and there could be several reasons for the same.

Many believe that the cause of nipple confusion or nipple preference is the fact that it is easier for a baby to suck milk from a bottle as compared to breasts. Others believe that the baby forgets how to latch on after learning how to drink from the bottle.

However, sucking milk from the breasts is something that the baby knows instinctively right from birth. A baby will not prefer to suck milk from a bottle unless he finds it troublesome to get enough milk from his mother’s breasts.

Signs of Nipple Confusion

Your baby finding it difficult or simply refusing to latch on is the earliest sign of nipple confusion and may happen when your baby is not getting enough milk from your breasts.

Some signs that your baby is not getting the required amount of milk from your breasts are:

• When the baby refuses to nurse
• When you experience breast engorgement. If your breasts are engorged with milk or your breasts have firm tissues, then it indicates your baby will not be able to get a good mouthful of your breasts and refuse to latch on.
• Sore nipples
• Slow down in the increase of the baby’s weight.
• Signs of a tongue-tie in the baby. This can make it difficult for them to breastfeed.

While these issues add to the problem, they should not be confused with nipple confusion. These are breastfeeding problems, and by getting rid of these, you can get rid of nipple confusion, too.

How Can I Prevent Nipple Confusion?

How to overcome nipple confusion is a common question that many nursing moms ask. Here are some of the tips that can help:

• Go back to the basics: You need to go back to the basics of latching on to make your baby realise how soothing breastfeeding is by cuddling him skin to skin. Typically, you will need a few sessions when your baby is fumbling with your breasts, but these sessions will help the baby root for and latch on to your breast.

• Make the milk flow smoother: You can do so manually, or you can even pump your breasts before your baby latches on. This will reduce the effort on the baby’s part.
• Timing is important: The baby needs to be hungry to latch on, and that is the only way by which you can motivate him to give it a try. However, that does not mean that the baby should starve as that will make him lose his patience to suck hard and get the milk.
• Keep faux nipples at bay: With babies frequently experiencing nipple confusion, it is best to keep bottles away. Stick to breastfeeding till you start giving him solid food. Make sure to keep away the pacifier too, if your baby has got too attached to sucking it.
• Avoid fast-flow milk: Babies will usually prefer bottle feeding if the bottle offers a fast flow of milk without much effort over breastfeeding flow. Although it is possible to get your baby back to breastfeeding, make sure the bottle’s pace is not fast.

Difference Between Breastfeeding Vs. Bottle Feeding

As per experts, breastfeeding is always a better option than bottle feeding. The mother’s milk is always at the right temperature, and it has the right balance of all the nutrients. However, breast engorgement, lack of time, etc., make bottle feeding the preferable option if direct breastfeeding is not possible.

How to Fix Nipple Confusion in Babies?

If you think that nipple confusion is causing a lot of problems for both you and your baby, you can seek professional help.

Additionally, mothers can opt for Paced Bottle Feeding method with a newborn teat to prevent nipple confusion. Paced Bottle Feeding allows a baby to be in charge of the flow of the feeding pace. This method ensures the flow of the milk is slow into the nipple, allowing the baby to feed slowly and reducing the risk of sudden overfeeding. This method works great for babies who are either fully bottle-fed or partially from the bottle and the breast. 

You can visit a breastfeeding counsellor or a breastfeeding clinic and learn the techniques of how to avoid nipple confusion. A counsellor will help you with the right techniques that might eliminate the problem immediately, or they will help you in finding out the problem that is making breastfeeding difficult for your child.

Can I Continue to Breastfeed My Child?

Yes. Exclusively breastfeeding your baby is probably the only way to deal with nipple confusion. If there are breastfeeding problems, then you should talk to professionals and find solutions to them.

Will Nipple Confusion Affect My Baby?

Breastfeeding is important as the mother’s milk is packed with all the nutrients, minerals, and vitamins that a baby needs. It is easily digestible as well. Giving your baby expressed milk is the second-best alternative to breastfeeding and often the best option when breastfeeding is not possible. Nipple confusion will not affect your baby as long as he is getting breast milk in some form.

Conclusion: Remember that nipple confusion does not affect your baby directly. However, If the above guidelines don’t resolve the problem of nipple confusion in your baby, consulting an expert is recommended without any further delay.

References/Resources:

1. Nipple Confusion; La Leche League International; https://llli.org/breastfeeding-info/nipple-confusion/

2. Nipple Confusion; La Leche League GB; https://www.laleche.org.uk/nipple-confusion/

3. Zimerman. E, Thompson. K; Clarifying nipple confusion; Journal of Perinatology; https://www.nature.com/articles/jp201583; July 2015

4. Ben-Joseph. E P; Breastfeeding vs. Formula Feeding; KidsHealth; https://kidshealth.org/en/parents/breast-bottle-feeding.html; June 2018

5. Paced Bottle Feeding: Infant Feeding Series; Minnesota Department of Health;
https://www.health.state.mn.us/docs/people/wic/localagency/wedupdate/moyr/2017/topic/1115feeding.pdf

6. Breastfeeding vs Bottle Feeding Formula; American Pregnancy Association; https://americanpregnancy.org/healthy-pregnancy/breastfeeding/breastfeeding-vs-bottle-feeding-formula/