Lawrence, Neifert, and Seacat, Nipple Confusion:  Toward a Formal
Definition, JPEDS, 1995, 126(6):125-9.

Type A:  "Describes a neonate's difficulty in exhibiting the correct oral
configuration, latching technique, and suckling pattern necessary to extract
milk from the breast after exposure to an artificial teat."

Typically this phenomenon occurs when an artificial nipple is introduced
before the successful establishment of breastfeeding.

"The term should NOT [my emphasis] be applied to situations in which a
newborn infant displays a primary inability to suckle the breast
effectively, without prior exposure to an artificial teat such as a bottle
nipple, pacifier or adult finger."

This is often the type baby I work with.  These kids CANNOT breastfeed
because something is temporarily or enduringly the matter with them or with
the maternal milk supply.  They are not confused, but dysfunctional.  Often
people call these kids confused because they can manage to stay alive when
alternatively fed but would starve at breast.

Type B:  describes "...an older infant who is proficient at breastfeeding
[who] refuses to drink from a bottle."

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com

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