If anyone ever deserved a break, it’s a nursing mom, so your desire to have your little one take a bottle so that you can go for a much-needed walk (or at least take a shower or a nap) is completely understandable, and in fact essential to your well-being. Show
But are you worried that your little one won’t take to the bottle easily? Heard one too many “nipple confusion” sagas from friends and lactation specialists? Or has that theory been discounted by the pediatrician and your mother-in-law, leaving you more confused than ever? Here’s the straight scoop. What is nipple confusion?Nipple confusion is a term used to describe babies who are used to sucking from bottles and have a hard time getting back on the breast. They may may protest the different size or texture of a mom’s nipple. Is nipple confusion real?A baby who seems more accepting of bottle-feeding than breastfeeding isn’t confused. She’s simply showing her inclination for drinking from the bottle. Here’s why that can happen: Newborns catch on pretty quickly that they don’t have to work nearly as hard to get milk from bottles with rubber (or silicone) nipples as from the breast. To breastfeed, your baby needs to master the fine art of taking your nipple far back into her mouth and then using her tongue to pump out the milk (which can take a minute or so before it starts flowing). With a tilted bottle, a baby has gravity on her side: She can suck with her lips and get all the milk she wants right away. So the baby suffering from nipple confusion may not be befuddled so much as opinionated. She prefers the bottle. And why wouldn’t she? It’s the quicker, easier route to a full belly. Bottle preference is far from guaranteed though. In fact, most babies have no problem switching from breast to bottle and back again — and some do so with ease from the get-go. But others, particularly those who take a little longer perfecting the art of suckling at the breast, do find it hard to transition from breast to bottle and then back to breast. Which is why most experts agree that you should wait until your newborn gets the hang of breastfeeding before you break out the bottle. When to introduce the bottleFor breastfed babies, three weeks is the sweet spot for bringing out the bottle. That allows for enough time for your milk supply to get well established and for your newborn to really master the technique. On the other hand, it’s still early enough in your newborn’s nursing journey that she doesn’t end up rejecting the bottle because it feels too unfamiliar. If you haven't hit your groove with breastfeeding by the three-week mark, ask your pediatrician if you should wait a little longer before introducing the bottle. How to help your baby switch from breast to bottleTo encourage your little sipper to switch more seamlessly from breast to bottle, stick with these strategies. Introduce the bottle at the right time.Wait to offer the bottle to your breastfed baby until about three weeks after birth. That’s enough time for you to establish your milk supply and for her to hone her nursing technique, but not so long that she ends up getting too used to the breast. Use the right nipple.What’s “right” ultimately depends on your baby’s preferences, so be willing to experiment with a few different options. That said, you might find the most success with a slow-flow nipple (sometimes called a newborn nipple). These tend to slow the pace of feeding, so it’s a little more like nursing. How can you tell if milk is flowing from the bottle at a good speed? The milk is likely coming out too fast if your baby is making gulping or sputtering sounds. And if she’s becoming excessively frustrated or seems like she’s straining, it’s probably coming out too slow. Don’t make it effortless.Remember, your baby has to work a little harder to get milk from your breast compared to from a bottle. You can slow the flow by holding the bottle at a tilt instead of vertically. Take frequent breaks to stretch out the length of the meal overall too. Will using a pacifier lead to a bottle preference?Despite what you might hear from well-meaning family or friends, offering your baby a pacifier won’t make her like bottle-feeding more or lose interest in breastfeeding. Not only can pacifiers soothe your baby while giving you a much-needed break, but offering them at nap and bedtime in particular may reduce the risk for sudden infant death syndrome (SIDS), according to the American Academy of Pediatrics (AAP). The key is introducing the pacifier after you’ve both gotten the hang of breastfeeding. Just like with bottles, you’ll want to wait to pop the pacifier until your baby is 3 or 4 weeks old, the AAP recommends. How to fix bottle preferenceIf your newborn seems to go gaga for the bottle and not much else, don’t worry. With a little time and effort you can undo that preference and steer her back towards the breast.
Newborns who’ve taken to the bottle but are still struggling with nursing often have trouble latching on properly. That might look like:
What to do if your baby prefers breastfeedingSometimes introducing the bottle to a breastfed baby (particularly if you wait more than three or four weeks after birth) can bring on the opposite problem: A baby who won’t take the bottle at all. That can be frustrating — especially when you could use a break or are getting ready to go back to work — but, again, is a speed bump you can overcome. Some tips: Let someone else do the honors.Sometimes a baby is just too attached to Mom’s nipple, so hitting the bottle while Mom is so close by (yet buttoned-up) seems wrong. But it may be a different story if someone else is bringing on the bottle — whether a partner, grandparent or best pal. But don’t worry that you’ll always need a Mommy stand-in at feeding time — once your wee one gets the hang of the bottle, she won’t care who gives it to her! Try different nipple types.If one bottle nipple doesn’t succeed, try, try another one. Just watch the flow rate. The milk should come out fast enough that your baby doesn’t get frustrated … but not so fast that she can’t keep up with the flow. A drop a second when you turn the bottle upside-down is just right. Make bottle-feeding as much like breastfeeding as you can.Interact with your baby. Switch arms halfway through so she has something different to look at. Burp her. But remember that while some newborns want bottle-feeding to be just like breastfeeding, others take to it better if the experience is completely different. So if that’s the case with yours, try a different location or even a different position. How to balance breastfeeding and bottle-feedingBottle- or breastfeeding doesn't have to be an all-or-nothing choice. By spacing out feedings, finding a formula that baby likes almost as much as mom's breast milk and including lots of skin-on-skin bonding, you'll be able to enjoy the flexibility of both.There are some basic mechanical differences between how a baby gets milk from a bottle and how it gets milk out of the breast. Giving bottles or pacifiers to young, breastfeeding babies often leads to nipple confusion. Baby tries to use the bottle-feeding technique on the breast and has difficulty latching-on and sucking. This can cause mother and baby frustration. Nipple confusion can even lead to baby refusing the breast. Here’s an explanation. How Babies Suck on the BreastTo get milk from the breast, baby must coordinate tongue and jaw movements in a sucking motion that’s unique to breastfeeding. When baby latches onto the breast, he opens his mouth wide and draws the very stretchable nipple and areolar tissue far back into his mouth. The tongue holds the breast tissue against the roof of baby’s mouth while forming a trough beneath the nipple and areola. The gums compress the milk sinuses underneath the areola (the pigmented area around the nipple) while the tongue rhythmically “milks” the breast with a wave-like motion from front to back, drawing the milk from the areola and the nipple. Since the nipple is far back in baby’s mouth, it’s not compressed by the gums, so it’s less likely to get sore.
How Babies Suck on a BottleBabies suck from a bottle entirely differently. Thanks to gravity, milk flows from a bottle so easily that baby does not have to suck “correctly” to get milk. He doesn’t have to open his mouth as wide or correctly turn out the lips to form a tight seal. The bottle nipple does not need to be far back into the mouth, nor is the milking action of the tongue necessary. Baby can lazily gum the nubbin of the rubber and suck with only his lips. When the milk comes out too fast, baby may thrust his tongue forward and upward to stop the flow from the nipple. Milk keeps on coming during feedings from bottles–whether or not baby sucks–so there are no pauses to rest during bottle-feedings. The ConfusionNipple confusion occurs when babies apply the lessons learned from bottle-feeding to nursing at the breast. When you compare the illustration of sucking at an artificial nipple with the illustration of sucking at the breast, you will see that if baby sucks from the breast the same way he does the bottle, the tongue and the gums will traumatize mother’s nipple. Babies who get bottles soon after birth may thrust their tongue upward during sucking and push the breast nipple out of their mouth. They don’t open their mouths wide enough when latching-on, so they suck only the tip of the nipple. They don’t get enough milk, and mother’s nipples get sore. Baby becomes accustomed to the immediate flow of milk that comes from the bottle. At the breast, babies have to suck for a minute or two to stimulate mother’s milk ejection reflex and get the milk flowing.
Is Bottle-Feeding Easier Than Breastfeeding?Yes, and no. Bottles require less sucking finesse and less effort. However, studies comparing premature infants during bottle-feedings and during breastfeedings have shown that breastfeeding is actually less stressful. Here’s why:
Preventing Nipple ConfusionIt is easier to prevent nipple confusion than to fix it–though it is a problem that can be solved, should it occur (see below). Breastfed babies should not be given artificial nipples during the first three to four weeks when they are learning and perfecting their breastfeeding skills. Avoiding artificial nipples means avoiding pacifiers as well as bottles. Supplements, if medically necessary, can be given in ways that don’t involve artificial nipples. (See Alternatives to Bottles.)
Will it be more difficult to introduce the bottle later? Many mothers, because they are going back to work or because they eventually plan to get out for a few hours by themselves, want their breastfed babies to accept feedings from bottles. They have heard stories of babies who adamantly refused anything but the breast. Getting baby to accept a bottle at age two or three months may take some patience, but most babies will catch on after a few tries. (Babies can also be fed with alternatives to bottles when mother is gone.) While introducing the bottle at one or two weeks of age may ensure that baby accepts the bottle later, you’re taking a risk. Some babies easily go back and forth between breast and bottle, but many others do not. Don’t jeopardize your breastfeeding relationship when it has barely begun. Undo Nipple ConfusionWhen a baby who is getting bottles begins to balk at taking the breast, nipple confusion is probably at the heart of the problem. Here’s how to re-teach a baby what to do at the breast:
Woo Baby Back to the BreastWhen babies are re-introduced to the breast they often act puzzled or uncertain. Be patient. Praise your baby for every tiny step she takes back to breastfeeding. It may take a few days to woo baby back to the breast, but you can do it. For more suggestions and support about breastfeeding and nipple confusion, get help from a La Leche League Leader or a lactation consultant. December 16, 2020 December 21, 2020 |