Lactnetters,
An interesting question arose yesyerday in my nursing clinical.   One of
the students did an extensive (she stated) lit search on nipple confusion
and could find no studies actually documenting this event.  As an LLL
leader I've been discussing this for years, but had not actually thought
about the research basis for this.  Of course, we all know about the
difference in nipple placement between the bottle and breast, and the
studies that have looked at that.  But we can't find anything that
actually gives findings other than anecdotal evidence.
Given the importance of research based nursing, this particular student
was questioning how she can point out the risk without research to back
her up.
If anyone is familiar with specific studies (presumably impossible to
control for all the variables, and, in my opinion, unethical to put a
baby at risk of confusion and possible decreased breastfeeding time),
please let me know.  I am checking the archives under "nipple confusion,"
but this is a long task.
Thanks for your help...Lee-Ann Halbert