My name is Tonya Stehno and I am a student nurse at the
University of North Dakota College of Nursing.  I have been reading the
posts about nipple confusion and I am also interested in this topic and
did some additional research concerning the topic.  There is controversy
in the literature concerning nipple confusion.  According to Neifert,
Lawrence and Seacat (1995), nipple confusion has never been formally
defined or widely acknowledged within the medical profession. In their
article, "Nipple confusion: Toward a formal definition"  they do
acknowledge imprinting and switching from breast to bottle as a possible
reason for nipple confusion.  On the other hand, the La Leche
League's Mohrbacher and Stock (1997) and Armstrong (1996) do
support the concept of nipple confusion and do recognize the need to put
the baby to breast within that critical period after birth. The LLL also
suggests establishing the baby on the breast for 4 weeks before switching
to a bottle to avoid nipple confusion.
        As a student learning more about breastfeeding, it is sometimes
difficult to sort through the conflicting information.  I have enjoyed
the discussion and have learned a lot following this topic on Lac Net.
Thank You for the information,  Tonya Stehno, Student nurse.

        Armstrong, H.  (1996) .  Adult nipple confusion: a commerciogenic
problem.  Journal of Human Lactation, 12 (3) , 179-81.

        Mohrbacher, N.  , Stock, J. , (1997) .  The Breastfeeding Answer
Book, (Rev. ed. ) .  Schaumburg, IL:  La Leche League International.

        Neifert, M. , Lawrence, R. ,  Secat, J.  (1995) .   Nipple
confusion: toward a formal definition.  Journal of Pediatrics, 126 (6) ,
S125-9.