Nipple Preference or Nipple Confusion

Babies were born to breastfeed. It is one of the few things full term babies know how to do the instant they are born. If you ever doubt this, watch videos of newborns who instinctively find their mother’s breasts and start suckling. It is nothing short of amazing. Nipple preference, sometimes called nipple confusion, may come into play if a baby shows more interest in a bottle or pacifier than nursing from the breast. Today we’re taking a look at nipple preference and how to avoid it.

Nipple preference usually occurs when a baby is unsuccessful at getting breast milk during nursing and instead is given a bottle where nourishment is readily available. Interestingly, it’s not that babies actually prefer a bottle nipple, but rather they are getting better results from it. Feeding directly from the breast is actually a baby’s first preference.

Nipple Preference or Nipple ConfusionThe American Academy of Pediatrics recommends not offering bottles – even of breast milk – for at least the first four weeks of a baby’s life. This helps solidify a breastfeeding routine by allowing mothers to establish a healthy milk supply and babies to feel confident in latching and in the comfort they get from breastfeeding. Introducing a bottle too early, whether it is because milk supply is low or out of convenience, can lead to nipple preference.

Milk supply takes time to develop. For the first few days after birth a mother produces colostrum, which is a thick paste-like substance that can sustain babies until their mother’s milk comes in. Although milk usually arrives within a few days of birth, it is not considered mature milk until three weeks after birth. Some moms experience low milk supply from the beginning, which may lead to bottle feedings earlier than four weeks. Other complications such as sore nipples and difficulty latching, or the emotional toll of having a new baby (including need for sleep and feeling frustrated that breastfeeding isn’t going smoothly), may also lead to early bottle feeding.

Bottle feedings can cause nipple preference when babies are having a hard time getting milk during breastfeeding and are better able to retrieve milk from bottles. However, bottle feedings can exacerbate breastfeeding problems because they interfere with the supply and demand process of milk supply and gets the baby out of the habit of feeding from the breast. Then breastfeeding vs. bottle feeding becomes a vicious cycle and can lead to early weaning.

Some people argue pacifiers can also cause nipple preference and should not be introduced until four weeks once breastfeeding is well-established. Like bottle nipples, pacifiers require a different mouth and tongue position than breastfeeding and may interfere with latch.

If you feel your baby is experiencing nipple preference work to increase your milk supply so your baby can get back to his instinctual desire to breastfeed. You can boost your milk supply by breastfeeding often (on-demand), emptying your breasts completely during feedings, not skipping a feeding by offering a bottle, eating a healthy lactation diet and pumping as necessary. Also ensure your baby has a proper latch so he can nurse effectively. If you run into breastfeeding problems, visit a lactation consultant right away to resolve them so you can stay on track.

Once your breastfeeding routine is well established occasional bottles and pacifier use is fine. If you are returning to work or need to be away from your baby regularly, gradually build up to more frequent breast milk bottle feedings. Be sure to pump whenever your baby has a bottle to keep your milk supply strong t avoid future nipple preference.

Sources: Ask Dr. Sears, BabyCenter and KellyMom