My husband did this one last week.  I thought that many people would
find it interesting.

The osteoporosis and breastfeeding references are still available
by direct email request.  I think it is too long to post in its
entirety.








         NIPPLE CONFUSION OR NIPPLE PREFERENCE IN HUMANS

SOURCE: MEDLINE 1966 - November 1995, abstracts are printed if available

     This search retrieved articles, only where the terms "nipple
preference" or "nipple confusion" appear in their titles or
abstracts.  Additional related material can be retrieved by
searching on "sucking behavior and human".


Unique Identifier:  95294679
Authors:  Neifert M.  Lawrence R.  Seacat J.
Institution:  Lactation Program, Presbyterian/St. Luke's Medical
              Center, Denver, CO 80218, USA.
Title:  Nipple confusion: toward a formal definition.
Source: Journal of Pediatrics.  126(6):S125-9, 1995 Jun.
Abstract
  The purposes of this article are to introduce a formal definition of
  nipple confusion and to propose various hypotheses concerning its cause.
  The term nipple confusion refers to an infant's difficulty in achieving
  the correct oral configuration, latching technique, and suckling pattern
  necessary for successful breast-feeding after bottle feeding or other
  exposure to an artificial nipple. Many early breast-feeding failures are
  attributed to nipple confusion, although scientific data are lacking to
  document its prevalence, the mechanisms involved, or various factors that
  predispose an infant to this phenomenon. Two classifications of nipple
  confusion are recommended to distinguish the impact of artificial nipples
  during the newborn period from their influence after breast-feeding is
  well established. Maternal and infant risk factors making an infant more
  susceptible to nipple confusion are discussed. Future studies are planned
  to help elucidate the nature of nipple confusion and identify the
  circumstances under which infants are most vulnerable to this phenomenon.
  Meanwhile, it would seem prudent for clinicians to identify newborns at
  risk for nipple confusion and to minimize the use of bottle feedings in
  such babies. Medically indicated supplements in the early days of life
  could be provided by alternative methods, such as cup, spoon, or dropper
  feeding, until breast-feeding can be established.


Unique Identifier:  93330677
Authors:  Fredrickson D.
Title:  Nipple confusion [letter].
Source:  Pediatrics.  92(2):300-1, 1993 Aug.


Unique Identifier:  93330676
Authors:  Auerbach KG.
Title:    Nipple confusion [letter].
Source:   Pediatrics.  92(2):299-300; discussion 301, 1993 Aug.


Unique Identifier:  93330675
Authors:  Heery LB.
Title:    Nipple confusion [letter].
Source:   Pediatrics.  92(2):299; discussion 301, 1993 Aug.


Unique Identifier:  93330674
Authors:  Mulford C.
Title:    Nipple confusion [letter].
Source:   Pediatrics.  92(2):298-9; discussion 301, 1993 Aug.


Unique Identifier:  93330673
Authors:  Newman J.
Title:    Nipple confusion [letter].
Source:   Pediatrics.  92(2):297-8; discussion 301, 1993 Aug.


Unique Identifier:  93330672
Authors:  Walker M.
Title:    Nipple confusion [letter].
Source:   Pediatrics.  92(2):297; discussion 301, 1993 Aug.


Unique Identifier:  90276749
Authors:  Musoke RN.
Institution:  Department of Paediatrics, University of Nairobi, Kenya.
Title:    Breastfeeding promotion: feeding the low birth weight infant.
Source:   International Journal of Gynaecology & Obstetrics.
          31 Suppl 1:57-9; discussion 67-8, 1990.
Abstract
  Though there is still some reluctance to use human milk for low birth
  weight infants, we have shown that it is possible exclusively to feed
  these infants on milk from their own mothers. The infants have adequate
  weight gain and are less likely to get infections, especially
  gastrointestinal and respiratory. It is possible to sustain lactation
  through manual expression during the period that the mother is not nursing
  her infant directly on the breast. A cup rather than a bottle can be used
  to feed these small infants. The mothers are thus encouraged because the
  infant does not suffer nipple confusion with a bottle and they continue
  breastfeeding after discharge from the hospital.


Unique Identifier:  89033260
Authors:  Neifert M.  Gray J.  Gary N.  Camp B.
Institution:  University Hospital, University of Colorado Health
              Sciences Center, Denver.
Title:    Factors influencing breast-feeding among adolescents.
Source:   Journal of Adolescent Health Care.  9(6):470-3, 1988 Nov.
Abstract
  During a 15-month study period, 244 adolescent mothers under 18 years of
  age were surveyed, of whom 53% elected to breast-feed. A subset of 60
  primiparous breast-feeding adolescents were studied regarding the
  influence of several factors on the duration of breast-feeding. An
  attitude questionnaire was administered in the hospital within 48 hours of
  delivery. Follow-up interviews were obtained by telephone or in person at
  approximately 2 weeks and 2 months after birth. Eighty-three percent made
  the decision to breast-feed before the third trimester. Thirty-five
  percent discontinued breast-feeding within the first postpartum month, the
  most common reason being "nipple confusion" in the infant; 22% nursed for
  more than 1 month but less than 2 months, and 43% breast-fed for 2 months
  or more. None of the variables examined (maternal age, ethnic group,
  education level, involvement of the baby's father, timing of the
  breast-feeding decision, intended duration of breast-feeding, age at which
  formula supplementation was started, or availability of maternal support)
  was predictive of the duration of breast-feeding. Contrary to adolescent
  stereotypes, 65% of mothers chose breast-feeding because it was "good for
  the baby," and 67% identified the "closeness" of the nursing relationship
  as the most enjoyable part of breast-feeding. Twenty-eight percent cited
  modesty issues about breast-feeding as the greatest disadvantage, and 17%
  returned to work or school within the first 2 postpartum months, posing
  additional obstacles to breast-feeding. Our data suggest that adolescents
  are receptive to breast-feeding, but they may require close follow-up and
  anticipatory guidance tailored to their individual needs.(ABSTRACT
  TRUNCATED AT 250 WORDS)


Unique Identifier:  76186952
Authors:  Christensen S.  Dubignon J.  Campbell D.
Title:    Variations in intra-oral stimulation and nutritive sucking.
Source:   Child Development.  47(2):539-42, 1976 Jun.
Abstract
  Sucking records were made from 24 infants, aged 3-4 days, fed small
  amounts of their usual formula from nipples of different sizes (5/16-,
  8/16-, and 11/16-inch diam). Polygraphic and observer measures showed that
  the large nipple elicited fewer sucks and a slower sucking rate; 5 infants
  seen on 2 successive days showed a more marked nipple preference on the
  second day. The results show that intra-oral stimuli control sucking for a
  nutriment in much the same way as they have already been shown to control
  nonnutritive sucking.


Sarah Friend Barnett, M.A., LLL leader, IBCLC
Bronx (New York City), NY
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