>
>
>I think that the real issue here is not nipple confusion, but belief in
>breastfeeding, and true skilled ongoing lactation support according to what
>we know as the body of lactation science.  Within the  discussion of "is
>there nipple confusion," the issue is simplified, and that there are those
>people who want an excuse to maintain a substandard level of breastfeeding
>support.
>
>That is my first take on it. There certainly are a lot of babies who would
>be breastfeeding perhaps, if they were fully and professionally supported
>through whatever difficulties they are having with bf. Despite the
>definition of "nipple confusion," or not.
>
>Kathleen

Yes.......well said, KB.

If bf support (of the informed, skilled kind) takes place alongside
the giving of bottles for whatever reason, we may well not see
'nipple confusion'.

This is certainly the view of the John Radcliff clinic in Oxford,
home to Chloe Fisher and Sally Inch. They do support mothers who are
using EBM, given in bottles, and work very hard to help the mother
and baby learn about effective bf as well. They say that when they do
this, the baby does not get confused. 'Confusion' happens when the
baby *chooses* the productive bottle over the non-productive breast.

In the past few years, since learning from Chloe and Sally about
their approach,  and reading their work, I have supported  many
mothers who have given bottles and who have returned to,  or
achieved,  full and happy bf. I don't talk about nipple confusion any
more.

The contents of the bottle should be EBM *whenever humanly possible*
to avoid the health risks of formula, to sustain the mother's
confidence that her body can do what it needs to do, to maintain her
breastmilk production.

In fact, sometimes the notion of nipple confusion doesn't help. It
has made some units think it is ok to give formula to a bf baby, as
long as it is in a cup or a syringe.  Quite, quite wrong......

I can understand why WHO recommends only cup feeding
though....bottles and teats are much harder to keep clean, are more
expensive and are not found in every household.

Heather Welford Neil
NCT bfc
Newcastle upon Tyne UK

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