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What is nipple confusion?

What is nipple confusion?
Nipple confusion is one of those terms that can be a little misleading. It doesn't mean your baby is confused about what your nipple or your breast is for. Nipple confusion is used to describe those times when a baby is reluctant to breastfeed, and seems to find it easier to bottle-feed expressed milk.

Bottle teats are fairly rigid, with a constant reservoir of milk, so your baby won't have to work hard to get at the milk he wants. But to feed from your breast, your baby must first open his mouth wide to latch on. Then he'll need to use about 40 facial muscles, which he'll work constantly to get his tummy full of milk.

So if your baby is reluctant to breastfeed, it isn't because he's forgotten how to breastfeed. Babies are born knowing how to suck. It comes naturally to them.

And it doesn't mean your baby is rejecting you. There can be all sorts of reasons why babies can't get the hang of breastfeeding. The usual reason is they are finding it hard to latch on.
My newborn isn’t latching on well and prefers a bottle. What should I do?
If your baby is struggling to latch on, ask your midwife or health visitor to refer you to a breastfeeding counsellor or infant feeding specialist. You can also drop into a local breastfeeding clinic if there’s one in your area.

Your breastfeeding expert may advise you to express milk to give to your baby in a bottle for the time being. An expert can show you how to encourage your baby to approach the bottle in the same way as your breast.

Your baby should gape his mouth wide open to the bottle teat, with his tongue down and forward. He should do this for every feed.

Try to give your baby expressed breastmilk, rather than formula. This will keep your milk flowing and give you a breathing space until you have both learned to latch on. It's unlikely that your baby doesn't want to breastfeed simply because he’s having bottles of expressed milk.
My baby breastfeeds well. Will it confuse him if I give him a bottle of expressed milk?
If your baby is breastfeeding well, there is no reason why you can’t give him the occasional bottle of expressed milk.

You may be told that if you express milk, it is better for your baby to drink it from a cup rather than a bottle. In fact, if your baby isn't having milk straight from your breast, it's unlikely to make any difference how he has expressed milk.

Feeding your baby expressed breastmilk, whether in a bottle or cup, is the next best thing to breastfeeding.

Try to express the usual amount your baby has from you over 24 hours. Then your breasts will still produce the right amount of milk the next day, and you won't get uncomfortably full.
Can nipple confusion cause breastfeeding problems?
It's very unlikely. Problems such as sore nipples and breast refusal, are sometimes blamed on nipple confusion. But sore nipples or your baby refusing your breast are most likely to happen because your baby is struggling to latch on well.

Your baby may just need more practice, or you may need some help from a breastfeeding counsellor to help him feed happily.

Some babies may have a condition called tongue-tie which makes it difficult for them to breastfeed. Or occasionally, mums have very firm breast tissue, which can make it difficult for a baby to form a teat shape in his mouth. Neither of these conditions is the same thing as nipple confusion.

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