Do we have research to show that all healthy normal babies can easily switch
back and forth between breast and bottle? In evolutionary terms, it doesn't
make sense to me - babies would evolve to breastfeed, not to alternate
between feeding methods.
I have certainly seen babies over the years who nursed well and gained well
and who developed problems when given bottles. Yes, I've also been able to
help many babies make the transition from bottle to breast. But I am
suspicious of a blanket statement that if a baby doesn't easily go back and
forth between the two, there must be a problem.
I know that when I started out helping breastfeeding mothers, more than 25
years ago, medical people felt that bottles could not interfere with
breastfeeding. It was the observations of mothers and people working with
mothers that created this theory of nipple confusion - seeing babies who,
after being given a few bottles, changed their way of sucking and latching.
Or who seemed unable to figure out what to do with a breast if they had
bottles before breastfeeding.
In our local hospital, mothers of premature babies are told they must give
their babies bottles before breastfeeding, and they usually leave the
hospital doing both. I frequently get calls from these mothers, as they have
significant problems in getting the baby to latch and suck well at the
breast. Now, certainly, these babies are premature and more likely to have
problems. However, we do have a few mothers who will refuse to give their
babies bottles and either supplement at the breast or have any supplement
given by gavage. Those babies breastfeed so much better when they are
brought home - the difference is quite noticeable.
Finally, I use the word confusion because I think it is less upsetting to
mothers. It is very upsetting emotionally for a mother to find that her baby
who has been given bottles now doesn't seem to know what to do with her
breast, or latches painfully, or lets go and cries because it isn't the firm
nipple with milk dripping out of it that he was expecting. To say the baby
"prefers" the bottle nipple says to many mothers that the baby is rejecting
her nipple and her breast - that he doesn't want to breastfeed. It feels
very personal. So I try to reassure mothers that the baby DOES want to
breastfeed, that her nipples and breasts are just perfect, but he's just a
little confused right now and we'll help him figure it out.
Teresa Pitman
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