Kathy said: 
It is anecdotal experience (as is much of what we  do).  In my
experience it 
is usually bottle PREFERENCE rather than  actual "confusion" that causes
a 
baby to refuse the breast after having  bottles.  >>
 
I agree that there are some babies who actually prefer the bottle.  
 
Correct me if I am wrong, but those babies who refuse the breast after
they have had a bottle are usually those who were not feeding
effectively at breast in the first place, were not removing milk, or
very little milk, and when they finally get a good  mouthful of milk
albeit from a plastic container with a silicone teat, of course they
will prefer the bottle to the breast!! ( remember the survival
instinct!!)  This can even happen in older babies when mom goes back to
work.    IN a case where a baby will not go back to breast after the
bottle, you will probably see very marginal weight gain, slightly
underweight babies, and moms who report that the baby seemed to be on
the breast all day and night.  Her milk supply has probably decreased
with poor milk removal and the baby is happy to find a more reliable
source of food.  
I have learned not to fear bottles, and also I have learned that babies
who seem to be nipple confused were probably not feeding well which is
why they got the bottle in the first place.  
My most surprising moment was recently when I had a 12 day old baby
whose MOM had been in ICU until that day, had not even seen her baby and
came to me for the first breastfeed.  This baby had gotten bottles, of
course, for 12 days.  The mom had not pumped, but I managed to squeeze
out a good amount of milk. ( Don't ask me why)   The baby went straight
onto the breast and latched and suckled as if he had been doing it all
his life!!  He was a healthy newborn, and he was doing what healthy
newborns are programmed to do.  I have no explanation, but it is written
in the literature that when there is a medical reason for giving
artificial milk, it does not seem to interfere with breastfeeding……the
mystery pearl.  
Then there are those babies who are born in difficult births, vacuumed
out, suctioned, etc, who just can't get it together to breastfeed,
whether they get bottles or not. The moms are induced, epiduraled, and
so edematous that their breasts are doughy and swollen and without
repeated RPS, no human infant can latch onto them.   We are not dealing
with normally birthed babies and this is what is making our work so
difficult in the last few years.  
Those of you who have been in the profession for at least 20 years: did
you see non-latching babies back then? And remember, babies were
separated from their mothers, suctioned routinely, there was no rooming
in, and babies were fed on strict schedules.  What is different now? I
don't think it is the bottles.  
 
Esther Grunis, IBCLC
 
 

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