Is Nipple Confusion Real?

  • By: Sandra
  • Date: March 18, 2022
  • Time to read: 7 min.

There’s a lot of debate surrounding the topic of nipple confusion. Some experts say it exists, while others claim it’s nothing more than a myth. So what’s the truth? Is nipple confusion real or not?

Nipple confusion is a real issue, but it’s often overstated and poor feeding problems are often misdiagnosed as nipple confusion

Is Nipple Confusion a problem?

Many moms worry about nipple confusion when they start breastfeeding because of the many myths and stories that are floating around out there.

The best way to avoid nipple confusion during breastfeeding is to be patient with your baby, keep trying different positions for feeding, offer both breasts at each feeding, offer the breast from different angles (sides), wait until your baby shows signs of readiness before introducing bottles or pacifiers, don’t switch sides too frequently while nursing (wait 20 minutes) and above all else trust yourself! If you feel like you need help getting started read this guide on starting breastfeeding.

What Causes NIpple Confusion?

Occasionally a baby will have difficulty breastfeeding normally. The reasons for this may include:

  • The infant is small, or born before the due date
  • A difficult or complicated birth
  • The infant or mother is ill, or recovering from illness
  • Structural abnormality of the baby’s face or mouth
  • Structural abnormality of the breast or nipple

Does giving your baby a bottle cause nipple confusion?

When poorly feeding infants are offered a bottle or any other form of artificial nipple like a pacifier, they then may appear to prefer the bottle nipple and reject the breast.

This is not nipple confusion, but an indication that the infant needs help to breastfeed successfully. In these cases, the baby’s refusal to breastfeed stems from inability rather than preference.

What is Nipple Confusion?

The term nipple confusion most appropriately refers to an otherwise normal infant who has had too many bottles before breastfeeding has been well established.

Sometimes nipple confusion occurs in an older baby, previously nursing well, whose mother has returned to work or school. If the mother’s milk supply is low due to lack of stimulation during separations, the baby may begin to prefer the quick, easy flow of bottle feeding.

Much as like when a child moves from a slow flow nipple to a fast flow one, they tend to prefer the speed of the fast one. A breastfed baby can be the same. If bottle feeding with artificial nipples is giving them much more milk that when feeding from their breastfeeding mothers, they will prefer the fast flow.

The key to reversing this situation is to re-stimulate the mother’s milk supply. Mothers also can gently re-focus on the breastfeeding relationship by nursing more often when at home with the baby and cutting back on the number of optional bottles. Exclusive breastfeeding might not be possible, but the goal should be to breastfeed as much as possible and supplement with formula only when necessary.

How to balance breastfeeding and bottle-feeding?

So is nipple confusion a real thing or not? The answer is yes – nipple confusion can be a problem for some babies, but it’s often overstated. If you’re having trouble breastfeeding, talk to your doctor or lactation consultant for help.

Baby Refuses Artificial Nipples

Another type of nipple confusion refers to a baby who refuses to accept a bottle! Breastfed babies love to breastfeed.

In such situations, offer the bottle in a low-key manner. Keep practice sessions playful. Reassure the baby often, and stop whenever the baby seems stressed.

By continuing to offer tastes from the bottle, the baby will soon get the idea. Some babies will not accept a bottle from the mother but will happily be bottle feeding from a father or a babysitter.

Some older babies prefer to drink pumped milk from a cup, or mixed with solids from a spoon. They may never need to use a bottle.

When to introduce the bottle?

If you are still undecided about whether or not to introduce a bottle, here are a few things to keep in mind:

Babies should be exclusively breastfed for the first six months of life. After that, they can begin to have solid foods while continuing to breastfeed. The World Health Organization recommends breastfeeding for two years or longer.

If you introduce a bottle too early, the baby may become confused and reject the breast altogether. If you wait until the baby is older, he or she may be more willing to try the bottle.

It is best to delay introducing a bottle until after breastfeeding has been well established – usually around four to six weeks.

If you are returning to work or school and need to pump milk for your baby, you can give expressed milk in a bottle. If possible, try to breastfeed at home as often as possible so that the baby will not become too attached to the bottle.

Benefits of Mixed Feeding

Breastfeeding moms will often find there are benefits to mixed breast and bottle feeding. Whether it is mixed breast milk feeding or even giving formula in bottles, there can be advantages. These include:

  • Bonding time for dad if this feeding a bottle
  • Mother’s nipples get a break! Useful if you are suffering from mastitus or have sore nipples.
  • The baby is getting milk from a bottle and the breast, so you are still providing milk even if you can’t or don’t want to pump at work
  • Baby will take bottles from anyone – great for daycare!
  • Formula feeding in a bottle allows your partner to feed the baby as well. This can be really helpful if you’re feeling tired or need a break. It can also help dad feel more involved in the baby’s care.
  • Some babies will take both breast milk and formula from a bottle. This is called mixed feeding. Babies who are mixed fed usually have no trouble switching between the two types of nipples, once breastfeeding has been established.
  • If mom is ill and supplemental feedings are needed then breastfeeding infants can be given formula via a bottle
  • If you’re going to be away from your baby for a while, you can give expressed breast milk in a bottle. This will help keep up your baby’s breastfeeding routine and ensure that he or she still gets the benefits of breast milk.

Pointers: If Your Baby Seems Nipple Confused:

Confusion by Experts

According to the World Health Organization, nursing infants should never be given artificial nipples.

However, in 2005, the American Academy of Pediatrics recommended that newborns be given pacifiers to guard against Sudden Infant Death Syndrome.

However, recent researchfound that the occurrence of nipple confusion solely in the context of bottle use and very little evidence to support nipple confusion in the context of pacifier use. So those mothers panicking about introducing artificial nipples like pacificiers can relax!

Do Type of Nipples Matter?

It may be that some nipples cause less confusion that other types. Will a rubber nipple over a silicone nipple make a difference? We’ve done research and so far there is limited and inconsistent evidence to support the theory that healthy babies really have a material nipple preference. The flow can give a bottle preference when breastfeeding infants are either getting too much or too little flow.

It is widely believed that a bottle or pacifier use should not be introduced before breastfeeding is well-established, usually around four to six weeks.

Should I worry about nipple confusion?

No, not as long as your breastfeeding is established. If you need more breastfeeding time to establish lactation, please consult a lactation consultant.

If you are using expressed milk or formula, it is safe to give your baby a bottle. If you’re worried about nipple confusion, try different nipples and see which one your baby prefers.

Choosing Baby Names x
Choosing Baby Names

Remember that every baby is different, so don’t be discouraged if your baby doesn’t take to breastfeeding.

How Do I Stop Nipple Confusion

If you are returning to work or school and need to pump milk for your baby, you can give expressed milk in a bottle. If possible, try to breastfeed at home as often as possible so that the baby will not become too attached to the bottle.

Most babies will prefer a real nipple so despite what well-meaning family and friends might say, don’t give up! Breastfeeding time can be such a special bonding time and even though you may need to introduce bottles, as long as you continue breastfeeding as well, your baby will benefit.

When to Seek Help for Nipple Confusion

If you have any issues with let down reflex or tongue tie issues, then nipple confusion may be a thing. To check for tongue-tie check your baby’s tongue with their mouth wide open and see if they have Trouble sticking out the tongue past the lower front teeth.

Tongue tie may affect their latch and give them difficulty sucking when they nurse. If you’re having latch problems, be sure to seek out a lactation consultant for help.

If you are having trouble with breastfeeding, please consult a lactation consultant or your doctor with any medical questions you may have. They can help solve the problem and get you back to nursing your baby successfully.

Low Down on Is Nipple Confusion in Babies Real?

Nipple confusion is a real thing. It affects breastfeeding and bottle-feeding infants, who can become confused by nipples to which they are not accustomed. So what should you do if your baby has nipple confusion? Consult with a lactation consultant or doctor for help!

So there you have it, everything you need to know about nipple confusion! We hope this article was helpful and informative. For more information on breastfeeding or bottle-feeding your baby, please consult a lactation consultant or doctor. Thanks for reading!