There is such a thing as nipple confusion! I believe that the term is often misused or another word would be appropriate. I know that any baby will go back to the breast after bottles. The problem is that most women don't have the patience to do it. Most women don't like to hear their new babies cry. The moms often feel that they're hurting their baby by making them take the breast. I don't think anyone here would disagree that babies take the breast best when nothing else has been introduced. Often mothers find that babies don't latch as well after a bottle feed. The American society in particular is so convinced that breastfeeding doesn't work. If the baby doesn't latch moms often feel, "Oh well, I'll just bottle feed." Rarely will a mom pump for more than a couple of months. Pumping breast milk and then feeding with a bottle is double duty. Who wants to do that? In many hospitals bottles are a part of the routine. If it takes the term nipple confusion to convince a nurse not to use a bottle for a normal, healthy, full-term baby, then I say use it. Sometimes bottles are necessary but often they are over-used and unnecessary. Our job as LLLL,CLE,PC,IBCLC,and any other person that wants to help, is to get the baby on the breast. I have wanted to post on a topic related for a while now. I know of many midwives who won't refer to LC's in their area anymore. The midwives often have patients that are given formula by LC's (just in case). They also have patients that are finger feeding or bottle feeding EBM for months. In my opinion we are to facilitate BREASTFEEDING from the BREAST! I do use finger feeding , bottles, SNS, etc. but only for a short time. I know that most of you use gadgets very carefully, as represented by the nipple shield thread.(By the way, I found that thread enlightening. I've never used a shield but I might consider it now, in special cases.) Unfortunately in this field of lactation we will never agree on everything. In that light. I don't think breastmilk should be associated with bottles. We are mammals, we feed our young from the breast. Mimi