Maybe we should look at all the types of "nipple confusion" before we say it
doesn't exist.

 We know that a few babies will change their suckle to a bottle suck from as
little as one bottle thus leading to "nipple confusion."   But did they have
a "bottle suck" to begin with?  I've had a lot of babies who've never had a
bottle or pacifier who have a "bottle  suck" they piston up and down, tongue
thrust or hump the posterior wave of the tongue. Didn't  M. Woolridge's study
say something like the way a baby nurses at the breast and sucks on the
bottle  were the same?

Another theory about nipple confusion is that the bottle nipple is a
supernormal stimulus.  The hard surface and long shape of a bottle nipple may
DULL the rooting reflex to the breast.  I've seen this quite often following
bottles and finger feeding. The baby gets up to the breast, roots like crazy,
may even get the nipple in his mouth but doesn't get the signal to close it
and suck. (Dare I say the only way I've found to fix this problem it to use a
nipple shield temporarily--one or two days.   I think I've had 2 babies in
the last year that never got used to the softer surface of mother's nipple.)

More often than "nipple confusion," I encounter something I call called "Flow
Preference."  Flow preference occurs because the bottle provides instant
gratification. (Baby latches on, takes one or two sucks and comes off
screaming)  So dripping milk or using a syringe to give that first burst,
works for them. I've also found Jan Barger's trick of a few drops of water to
wet the nipple or the inside of the baby's mouth works.

Maybe the term itself is the problem. Do baby's really get confused? No, they
do what works.
Marie Davis