> If nipple preference does not exist, then what is going on when mom
> introduces a bottle 2,4,6, even 8 weeks postpartum and baby gradually weans
> from breast to bottle over the course of the few months that follow?  I saw
> this countless times in my work with League.
Good question.  I suspect that these moms are giving "relief bottles" and NOT
emptying (pumping) their breast at the time the bottle is given or they could
be using a bad pump.  About 60% of my moms return to work in 6-12 weeks and I
have very few moms who have supply issues or babies who wean from the breast
to the bottle even though they are having 2-4 bottles per day while mom is
pumping in the workplace.  These babies don't seem to get nipple confusion or
nipple preference, they go to whichever so long as they are getting milk.  If
the supply is kept up, baby's seem to prefer mom over the bottle.  I've had
several moms explain that their baby takes bottles fine while they are at
work, but if they try to give a bottle themselves the baby refuses and insist
on the breast.  I explain that the baby prefers to eat at a 5 star restaurant
(mom's breast) and not fast food.  Many of my moms breastfeed a year or more.

I always explain supply and demand in detail and I emphasize the importance
of respecting the system.  Many think that the breast are like the kitchen
faucet and they can turn them on and off anytime and get whatever they like.
I explain if they are going to give a bottle of pumped milk while out
shopping or dad feed the 2:00 am feeding, they need to pump at the same time
that the baby takes the bottle.  They either use it or lose it.  I tell
mothers if it didn't work that way, I would still have milk and I haven't
nursed a baby in over 24 years.
When teaching mothers about breastfeeding, we can NEVER assume that they
understand supply and demand or the making of milk.  I wish every mother that
buys a breast pump or plans to use bottles could have a consult with a LC to
teach her how to protect her milk supply.  (BTW, my baby turns 27 tomorrow!)

Warm regards,
Pat Lindsey, IBCLC - Lactation Services  www.PatLC.com
Pediatrics Plus' Lactation Consultant   www.pedsplus.com

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