Sheri wrote re nipple confusion: >Pardon me if this is a stupid question, but are you saying 10 percent of the >BREASTFED baby population? >Or the baby population overall? My LLL Breastfeeding Answer Book quotes >something much higher, like a rate of nipple confusion somewhere >around 95% for all breastfed babies given bottles or pacifiers. (I'm not >sure exactly on the percentage, but I could check if anyone wants >to know exactly what it reads). This sounds odd to me. Does it really say this? I certainly believe in nipple confusion, BUT only in a *very* small percentage of babies. In Australia we have very high initiation rates for breastfeeding (with lots of problems and high drop-off rate later), but I have only seen the occasional *true* nipple confusion. The problem is that you don't know beforehand which babies are going to be prone to this, so you try to be aware of it for all. What have others found? Is there actually any evidence that pacifiers alone (ie without bottles) can cause nipple confusion, or is it just an assumption or speculation? If it is primarily caused by the baby trying to control the flow of milk from the teat by pushing back with the tongue, this shouldn't arise with pacifier sucking alone. I think this should be carefully looked at as it may effect practices in NICUs with premmies, where they often use pacifiers while tube feeding to help babies to associate sucking with feeding. I think someone actually asked about this very recently - what other hospitals do. One of my soap boxes is that a manufacturer should develop a pacifier designed for breastfed babies - one that is longer and wider than standard ones. I know some of you will be reading this and saying "but breastfed babies shouldn't need pacifiers", but in the real world many do use them, and many parents want to use them, particularly with babies suffering with 'oversupply colic', etc. When parents want to use them and they complain the baby spits them out, I explain that they are designed for bottle fed babies, as they are the shape of a bottle teat, and don't go far enough back in the mouth to feel 'right' to a breastfed baby. I tell them that bottle fed babies need the extra sucking because, unlike most breastfed babies, they may not get enough (sucking) when they get their feed so quickly from a fast-flowing teat on a bottle. I suggest that they try pacifiers that are marketed for older babies, so that they are bigger and longer. The breast doesn't change size as baby grows bigger - why should teat/pacifier sizes be changed? When I had my first baby, I am sure they didn't have all these different sizes available (but the memory is a bit dim). Joy Anderson IBCLC NMAA Breastfeeding Counsellor Perth, Western Australia [log in to unmask] BTW I thought Nicole Bernshaw's post about breast exposure and culture/attitudes, etc was brilliant. I could even relate to her bit about women's unshaven legs! (This is not just North American - it's Australian too)