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Subject:
From:
"G. Hertz" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 29 Mar 2000 22:50:41 -0800
Content-Type:
text/plain
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Debbie writes:
Nipple confusion can be said to exist when, a baby who previously
> demonstrated effective breastfeeding, and who is then fed one or more
times
> with an artificial nipple, subsequently exhibits ineffective breastfeeding
> that can be characterized as the baby having a shallow latch and/or
> tight-lipped mouth with jaw clenching and/or tongue thrusting.
>
> As opposed to *Artificial Nipple Preference*:
>
> Artificial nipple preference can be said to exist when, a baby who has
been
> initially fed with an artificial nipple, can demonstrate effective
> breastfeeding latch, but quickly refuses breastfeeding, or, a baby who
> previously demonstrated effective breastfeeding, who is then fed one or
more
> times with an artificial nipple, is subsequently not confused at all, he
> knows exactly which nipple has the easier and faster flow. The term
> "easy/fast flow preference" may be more accurate.
>

Sounds pretty good.
So for nipple "confusion"...
We have:
1. must have fed effectively
2. been exposed to another feeding method
3. demonstrates ineffective feeding when initial method reintroduced
this appears to be related to (a.) baby related mechanical [latch]
problems - too shallow, tight lipped, jaw clenching or tongue thrusting
{this appears to be difficulty in adaptation to different oral motor skills
required for different feeding methods}

and for nipple "preference"
We have:
1. must have fed effectively
2. been exposed to another feeding method
3. demonstrates feeding reluctance or refusal when initial method
reintroduced
may be related to (a. ) oral stimulation changes - increased or decreased
flow, pressure on the palate

Can we add anything to this?  Any thoughts?

Gail S Hertz, MD, IBCLC

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