Dear Germaine, 

I have run across this expression many times myself. "breastfeeding well-established" will vary from one mother-baby dyad to another. What I suggest is that "well-established" is when baby is having appropriate wet and dirty diapers for age, is gaining steadily and is past birth weight, mother's breasts are fuller before feeding and softer afterward, mother's nipples are not sore with latch or feeding, and latch for baby is automatic and without need for much guidance from mother. When all those criteria have been met, a baby is pretty much a pro with breastfeeding and less likely to be confused by an artificial nipple, whether it be a pacifier or a bottle, and unlikely to form a preference for the artificial nipple, either. Well-established breastfeeding - meeting this criteria - can happen most generally by about the 4th week but certainly some babies can get their act together within a few weeks where others are still needing a good bit of mother assistance up until 6 weeks or so. 

As a side note - Most mothers I've asked have felt they finally felt breastfeeding was settling into place by about 6 weeks- about the time, sadly, many are heading back to work and don't get to enjoy how easy it is then because they've had to add bottles and pumping into the mix. 

I hope this helps, 

Cindy Garrison, BS IBCLC 
practicing in Pittsburgh, PA 




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