This is very late, but I had to put in my two cents.
I believe it is more the preformed shape of artificial teats which causes
the baby to be unwilling or unable to latch onto the breast, which must
be actively shaped (stretched) than differences in sucking patterns
between breast and bottle.  Perhaps we will have more credibility with
the 'nonbelievers' in nipple confusion if we are more precise in stating
the problem.  If an infant becomes accustomed to approaching an
artificial teat with a small gape and a retracted or neutral tongue and
tries to use this strategy on the breast, they will get the tip of the
nipple, no stimulation to suck, and little milk.  If a parent insists
they need to use a bottle, I recommend a nipple/teat with a large
diameter base, and show the parents how to stimulate the baby to gape
widely and "latch" onto the bottle teat, so that the lips land on the
wide base of the teat.  I have seen less breast refusal with bottles used
this way than 'shoved' into the baby's mouth.
        I have also found preterm or ill infants to be more flexible than
full term infants in transitioning from bottle to breast.  Perhaps
Chloe's sample is mostly the former, so she is seeing less breast
refusal?
--
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]