There IS such a thing as nipple confusion.  As a private practice LC I see
it often.  We shortchange our mothers and babies when we declare that
because some babies will go easily from bottle to breast there is not a
problem with early use of artificial nipples.  I am certain that the many
babies who are breastfeeding fine and whom I never see, most likely were
given bottles or pacifiers.  This doesn't prove that there isn't risk in
using such.  There are also mothers who have epidurals whose babies latch on
well the first day of life.  There are babies fed abm who don't develop the
many serious health problems we are becoming familiar with.  Are we ready to
say that, therefore, abm doesn't compromise a baby's life-long health? We
are talking about RISK here, not absolutes.

We have to remember that we are working with those mothers who do want to
b'feed and who are willing to seek help in resolving their problems.  The
many babies who, after having a firm object put into their mouths out of
which nourishment comes, find it very difficult to then draw the breast deep
into their mouths, implement the proper tongue and jaw movement, stimulate
several MER's--most of these babies will never see an LC. Mother will try,
and will conclude that her baby is happier with a bottle. Or she will decide
that the terrible nipple pain is more than she can deal with.

Imprinting is real, but babies differ in their adaptability ( and everything
else).  As one LC says,"If some babies see a picture of a bottle they will
become nipple confused."  And as Toby said, they don't come with labels.  So
we must be relentless in our efforts to put bottles as last resort instead
of first, just as we must work to educate about birth medications, and gut
permeability to foreign proteins, and the difference between breastfeeding
and breast milk feeding--on and on.

We do disservice to mothers and babies when we echo those who declare that
there is no problem with bottle supplements in hospitals just because it is
easier to feed that way, and it looks so familiar.

Nipple confusion is REAL and it is a serious problem for the baby who is
struggling to learn how to feed herself, and for the mother who so wants to
feed her baby at her breast.