Oh dear, did we have to bring this one up?

Well, I would remind everyone that sticking an artificial nipple into a
baby's mouth is not physiologic--no mammal ever did that until very very
recently in mammalian history.  Thus, the onus is not on those of us who
believe that nipple confusion exists to prove that it does.  The onus is
on those who deny its existence to prove that their intervention is not
harmful.  This has never been done, so they should refrain from using an
intervention which has never been shown to be harmful.  Furthermore,
since we have other ways, quite safe, efficient ways, of feeding babies
who will not take the breast without using an artificial nipple, why
bother using an artificial nipple unless there is absolutely no choice?
I have advised mothers to use bottles, but only occasionally, because
the other methods were not working well, but the bottle is at the bottom
of the list.  I really wonder how people who call themselves scientists,
who would never accept that unphysiologic conditions be considered the
norm in any other situation, would expect that it is the non
interventionists who have to prove the case that the intervention
(stuffing a nipple into a breastfeeding baby's mouth) is not harmful.

A baby who has been fed by bottle only for the first, say, three weeks
of his life is very reluctant indeed to take the breast.  If a mother is
breastfeeding a 2 month old very well, is told by some ignorant health
professional to stop breastfeeding because she is put on amoxycillin for
no good reason for 10 days, and she then tries to put the baby back to
the breast after 10 days off, despite maintaining a good supply, is that
baby going to take the breast?  He might, but chances are he won't, and
he will continue to take the bottle very well.

I am always interested how so many of those who deny the existence of
nipple confusion advise breastfeeding mothers to start the bottle within
the first few weeks of a baby's life, or "he won't take a bottle you
know" (what a tragedy!).

Chloe Fischer (at John Radcliffe) does not believe in nipple confusion.
If every health professional had her skills at helping mothers
breastfeed, there wouldn't be any such thing as nipple confusion.
Unfortunately, the vast majority do not have her skills, and thus should
be very reluctant to step into muddy waters (is that a mixed metaphor?).

Jack Newman MD, FRCPC

PS I do not believe that only 1 in 600 would not eventually take the
breast, despite Chloe's unmatched skills.