I do think it is good to remember that while most or many babies may be able 
to go back and forth readily between breast and bottle, some babies find it 
very difficult.

I worked with a mother who exclusively breastfed for six weeks, then left 
the baby and a couple of bottles of milk with a sitter so she and her 
husband could go out. The baby took the bottle without much difficulty, but 
when the mother went to breastfeed him again, he had difficulty latching 
well. Feedings were painful all the next day but then went back to normal. 
She went out again with her husband a week later, and had the same 
experience. Just a couple feedings from a bottle seemed to significantly 
disrupt this baby's latch for a day or two. I don't know what would have 
happened if she had been giving bottles more often.

I also see babies where the latch deterioration is fairly gradual. It seems 
to be okay in the beginning, and then a few weeks later the mother tells me 
she is finding her nipples are sore or tender or that the baby seems to be 
nursing for a long time yet still hungry at the end of the feeding. When you 
watch the baby nurse he seems to be either slipping back to the end of the 
nipple as he nurses or doing weird things with his tongue. So I think it is 
important not to assume "all is well" because for the first week or so the 
baby seems to do fine with both breast and bottle.

Teresa Pitman 

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