Donna wrote: <One mother came to our monthly new mothers networking meeting last week, very upset that her 3 month old was refusing to nurse, screaming very soon after latch on. This baby was being given one bottle of expressed milk a day from almost birth (their idea) so it really wasn't a nipple confusion. I did get the baby to nurse after the meeting and the mom cried - - she thought it would never happen again. The strange thing that came out of this through a discussion on the flu vaccine, was that this mom had the flu shot on sat and this all started to happen on sunday. . . Has anyone heard of a baby refusing to nurse after mom got the flu shot?> 1) I haven't met a mom/baby dyad where baby seemed to refuse the breast in response to mom's flu shot, but anything is possible. 2) Re: your statement that baby was being given one bottle of expressed milk a day from birth so it really wasn't a nipple confusion. What about nipple preference? The baby wasn't confused, I agree. It was a clear refusal by the baby. You describe the baby as latching on and then screaming. Breast refusal seems more likely to occur without any latching, so could it have been something to do with the flu vaccine?? In cases of nipple confusion and nipple preference, here is how I explain to parents and staff about the difference between the two. Nipple confusion looks like this: after having had exposure to an artificial nipple, either bottle nipple or pacifier, a baby is still willing to root for the breast but just doesn't seem to remember what to do at the breast (in cases where the baby has previously displayed sustained latch and nutritive sucking). This can also occur when baby has never successfully latched on to the breast, has had exposure to artificial nipples, and is still interested in rooting toward the breast. These situations are extremely common when babies who have been observed to have a good feed at the breast, are later sent to the nursery for overnight bottle-feeding by the nurses, followed by difficulty at the breast the next morning. Nipple preference, on the other hand, is a clear preference expressed by the baby. Among breastfed babies, this will either appear as a clear preference for the breast with refusal of artificial nipples, or the preference may appear in favor of the artificial nipple with a refusal of the breast. The baby's refusal may be adamant (crying and/or screaming and/or pushing away from the breast, which may be felt by the mother as a rejection of her mothering). The baby may also refuse the breast with "good manners" by simply turning away from the breast in a quiet manner, appearing to be consistently not interested in the breast. Of course this can occur among all babies, breastfed and bottle-fed alike. Many bottle-fed babies develop a very clear preference for a certain brand of artificial nipple. "What is nipple confusion?" and "Why does it happen?" are common questions that come up in prenatal bfing classes. It's important to let parents know that whether some nipple confusion occurs or whether the more advanced situation of nipple preference occurs, lactation consultants are skilled and available to assist families with such situations. I have met countless mothers in the immediate postpartum who very sadly refer to a previous child who had been bf for x period of time and then began refusing the breast after highly variable lengths of time with artificial nips - - one week, two months, four months, even one baby who at eight months rec'd his first bottle of EBM and then refused the breast after that one bottle. Mom's next babe was in NICU for two months - - with that babe she pumped for two months and then went to AIM, babe didn't ever go to breast. I met her after the birth of her third child. All was going well but she was adamant that this baby would NEVER have a bottle. I still remember her emotional delivery of that statement. While empathizing and having great compassion for mothers and babes in such situations, I reassure mothers, in an upbeat manner, that this is almost always a fixable problem and to give us a call, should such a problem occur with this new baby. Such a problem can be felt as absolute, however, putting a fast end to breastfeeding. It's important to emphasize that we're here to help mothers and babies with those situations and any other breastfeeding situation that needs addressed. There are many analogies to use in explaining why nipple confusion and nipple preference can happen at any time, even in an older baby. These analogies are also helpful when a mother is becoming chagrined and even worn out by a baby who continues to need a great deal of help in learning to latch on. I like to use the analogies of learning to ride a bike or to play a musical instrument. When we first begin to ride a bike without training wheels, we jump on and fall off many times. Then after several more tries, we start to have a little success but are still a bit wobbly. As we become more and more skilled in riding the bike, we don't wobble any more. And when we really have all those motor skills figured out, we just glide along and it's smooth sailin'. This is easiest if our parents buy us only one kind of bike for us to first learn how to ride. Providing us with a 3-speed, a 5-speed, a mountain bike, and a Big Wheel would stress anyone out! You can apply similar analogies with learning a musical instrument. Parents typically provide their child with one new instrument to learn in the beginning vs. starting their child on two or more new instruments. How stressful for the child or any new learner, including adults, to begin taking violin lessons on the same day you are beginning guitar lessons! These analogies are helpful when a family keeps pulling out a bottle in between your visits, as they continue to call you for assistance in helping their baby learn to breastfeed. Learning to eat, learning to ride a bike, learning to play soccer or a musical instrument - - these are all motor skills that improve with practice! I received a flyer some months ago for a workshop where Diane Weissinger was to speak on the use of analogies. Diane, if you're listening - - do you have any other analogies to share? Debra Swank, RN BSN IBCLC RLC Member of the Valerie McClain Fan Club Winchester, Virginia USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html