Barbara, I hate to be in the position of disagreeing with you, but I want to
share some of my experiences. If I understand you correctly, I think you are
suggesting that nipple confusion is not really caused by the bottle, but is
a symptom of a baby with a sucking (or other) problem of some kind.

I think that sometimes it is a symptom of problems, and that babies with
sucking problems are much more likely to develop confusion if given rubber
nipples. I also am convinced, though, that many babies who develop nipple
confusion do not have sucking problems otherwise.

Back in the old days when I had my first couple of babies, the hospital
routine was to give all babies bottles after birth, to "check them out"
before allowing them to the breast. I can tell you (I was a LLL Leader at
the time and saw a lot of mothers and babies) that a high percentage of
those babies - probably about half - then developed nipple confusion. I
could see them trying to come to the breast as though it was a bottle
nipple - small mouth, tongue back, etc. It often took a lot of work to get
the baby nursing and sometimes, if the mother was feeling stressed out by
the whole thing, it never happened.

Now I don't believe that all those babies had sucking problems. And when the
hospital policy changed and those early bottles were no longer given, the
number of babies I saw with this problem dropped dramatically.

Secondly, I continue to see babies who have been breastfeeding beautifully
for a couple of weeks when the parents decide to introduce bottles. The baby
then begins to nurse at the breast incorrectly. The mothers call me because
they suddenly have very sore nipples or can't seem to get the baby to nurse,
and again it sometimes takes quite a bit of work to correct the baby's
sucking technique.

Yes, there are babies who go back and forth between breast and bottle
without any problems. But I don't think that indicates that all healthy,
normal babies can do it. I think babies with some underlying feeding
problems are more likely to be confused by bottles, but I think it can
happen to other babies, too.

Just my experience.

Teresa Pitman