I have been following the discussion on whether there is such a
thing as nipple confusion with great interest. I have too many
babies who have catagorically refused the breast after having been
given artificial nipples to doubt that such a thing exists. I think
that the real question is how to get those babies back on the breast
again. As others have said, a lot depends on the mother's attitude,
but I think that the baby's personality must also be considered an
important factor. It takes two to breastfeed!

I have helped babies get back on the breast by using a three phase
program. I am careful *not* to mention specific time frames!
In the first phase, the mother pumps and feeds her milk to her baby
without using any kind of nipple, e.g. a cup, oral syringe, eye-dropper
etc. The baby is allowed to suckle only on a finger, and the mother
is shown how to "train" him to suckle correctly, that is, in a
breastfeeding mode with the tongue under the finger.
In the second phase, in addition to everything in phase one, the baby
is encouraged to nurse at the breast for comfort *after* each feeding.
In the third phase, the baby is artificially fed minimally  and then
put to the breast to encourage ad lib nursing. Mothers are encouraged
to sleep with their babies thoughout and are told not to be surprised
if their babies latch on spontaneously while they are sleeping. Of
course, this is often what actually happens! I also like to keep things loose, so that the mother is free to go back to a previous phase if the
baby seems stressed out.


Norma Ritter, LLLL, IBCLC
"If not now, when? If not us, who?"
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