>This is difficult. My fear is that if we (breastfeeding advocates) start
>saying nipple confusion doesn't exist, HCPs are going to become even
>more casual about using a bottle for every known problem with
>breastfeeding.


I agree, this is a risk, Anna....but we are not saying nipple confusion
definitely doesn't exist. What we are saying is that the terminology may
not be right, we don't know enough about it to be dogmatic, and that all
interventions (whatever they are - bottles, cups, shields, supplementers,
pacifiers etc etc) should be seen as interventions, and to be used only
with informed consent of the mother, and crucially,  with on-going support
and follow-up from someone who knows what they are talking about.

Sometimes, esp. when bf has been messed-up, interventions are necessary.

In the UK, bottles are used less often than they were in maternity units
(though they are still used far too often) and in some places, they have
been supplanted with cups.

I would like to see a proper study done on the use of cups with term
babies, as I think they have the potential to mess up bf just as much as
bottles do.

We shouldn't 'hide' information away from health professionals - though I
know the temptation to do so is great, because so often, they misinterpret
it, to the detriment of bf. Look at the way hindmilk and foremilk research
had so many 'helpers' telling mothers they had to feed *at least* 10/15/20
minutes (or whatever) a side at every feed or the baby 'wouldn't get the
hindmilk' - which just encourages clock watching, instead of baby watching.

Heather Welford Neil
NCT bfc Newcastle upon Tyne UK

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