Here are some of my observations about nipple confusion. When my first baby
was born, some 25 years ago, the rule was that all babies had to have a
bottle after they were born and before they went to the breast. This was
considered necessary in that hospital so that the nurses could observe the
baby sucking and swallowing to be sure he was okay before he went to the
breast. (I did manage to avoid this with my son, but it was the routine). I
saw many mothers with very sore nipples and babies who weren't getting much
milk, and when I watched them nurse it seemed clear to me that the babies
were trying to latch on as though the breast was a bottle. Perhaps it was
because they'd had that bottle as the very first feeding. But those babies
were clearly doing something quite different with their mouths and tongues
than my exclusively-breastfed baby did.

I have also seen some cases of what I would call "late-onset" nipple
confusion. One example: a baby who had been nursing just fine for about four
weeks. At that point, the mother left the baby with a sitter the baby had
two bottles during the evening. She called me two days later with very sore
nipples. Her report was that the baby latched and sucked differently after
getting the bottles. We were able to get the baby nursing well again, but it
took real work.

I like to call this problem - whether it relates to the flow of milk or the
different type of nipple or something else - "nipple confusion" rather than
"nipple preference" or "breast aversion" when I am talking with mothers,
because I find some mothers whose babies react this way take it very
personally. It upsets them emotionally to feel that the baby prefers the
bottle nipple or has an aversion to their breasts. Instead, I try to suggest
that the baby does want to breastfeed, does want his mother's breast and
nipple, but is just a little confused at the moment.

Teresa Pitman
Guelph, Ontario

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