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Conquering Confusion
Why Artificial Nipples Could Hurt Instead of Help By Michele St. Martin
Nipple confusion, also known as nipple preference, can occur when artificial nipples are introduced to babies before breastfeeding is well established. It happens because the baby learns to use the artificial nipple of a bottle or pacifier, and then has a hard time making the adjustment to the different way of sucking at the breast.
There are some members of the medical community who question whether nipple confusion exists, but most lactation consultants will tell you that they see it frequently. As with most other difficulties new breastfeeding mothers may experience, nipple confusion can be overcome.
- A baby may accept the breast but refuse to suck.
- A baby may refuse the breast altogether.
- A baby may attempt to suck but latch incorrectly.
The latter is what happened to Alttara Scheer of Hartsdale, N.Y. Scheer's son, Cullen, experienced a severe case of nipple confusion – he spent the first few days of his life in the NICU, and she wasn't permitted to nurse him for the first day. On day two, Scheer began to breastfeed her son, but was told that her son couldn't come home until either her milk came in or until she gave permission for Cullen to drink formula. "Of course, I wanted my baby home with me!" she says. "The sooner the better. And, since I was initially not allowed to breastfeed him, my milk was slow to come in." Scheer agreed to the formula ("Under duress!"), and that was the beginning of two and a half months of agony.
Her son's nipple confusion led to "agonizingly painful" nipples and a bout of thrush that took Scheer more than two months to clear up. Not only did the hospital insist on the formula, they also gave her son a pacifier despite the sign on his isolette stating, "Exclusive Breastfeeding." Scheer feels that the introduction of the pacifier aggravated the problem.
Fortunately, cases like Scheer's are becoming less common, according to Ann Calandro, BSN, RNC, IBCLC. Calandro says that hospitals are becoming more "baby friendly" and giving bottles less often.
Calandro also says that nipple confusion is most likely to occur in the baby's first month of life. "Lactation consultants always recommend that (babies) receive no bottles in the early days," she says. "They need to learn correct breastfeeding first." Calandro advises waiting to introduce a bottle until breastfeeding is firmly established.
Sometimes nipple confusion occurs because of a well-intentioned act: introducing a bottle so that the baby's father can bond with the baby through feeding. There are many other ways for Baby and father to bond besides the father feeding the baby, says Calandro. Scheer agrees, saying that her husband did "everything but feeding! Changing, holding, just spending time with the baby. Eye-to-eye and skin-to-skin contact."
Dawn Berry of Kennedale, Texas, echoes this, adding that her husband, David, talks to their baby, Trey, a lot. "Trey has always responded to David's voice," she says. "There are times that the only thing that soothes Trey is David's voice."
