What is nipple confusion? Nipple confusion is a phenomenon in which a newborn baby does not suck or does not want to suck on the breast because he or she sucked on a bottle before sucking on the mother’s nipple, or because he or she uses the bottle frequently. The reason it is called “confusion” is that the movements and techniques for sucking on the breast and the bottle are different, and after the baby gets used to the bottle sucking, there is technical confusion when sucking on the breast. Sucking on a pacifier requires only a gentle sucking of the mouth and the milk from the bottle flows out because of the negative pressure in the mouth. In contrast, sucking on the breast requires the baby to use the tongue and jaw in conjunction with squeezing the areola position. Babies are born knowing how to suck, but they eat breast milk differently than they do with a bottle. Some health professionals believe that if a breastfed baby is given a bottle during the first few weeks, it may lead to nipple confusion. They believe that if you give your baby milk from a bottle, it will be difficult to get him to eat breast milk again. There is no evidence to suggest this, though, and if the baby sucks on something else, he forgets how to take the breast. Nipple confusion has now become one of the most important causes of breastfeeding failure. Many parents and sister-in-laws do not pay attention to or understand how to achieve successful breastfeeding and feed their newborn baby with formula in a bottle early on. Soon, the baby falls in love with the ease of sucking on the pacifier and becomes familiar with the technique of sucking on the pacifier and has no interest in sucking on the mother’s nipple nor does she know how to do it. When the baby cries and refuses to suck on the mother’s breast, the family is distressed and anxious, and they don’t know how to correct the nipple confusion, so they feed more and more formula and less and less breastmilk, and slowly there is no more. Misconceptions about nipple confusion: Some mothers think that breastfeeding is not the same as bottle-feeding, but also to save the child crying and crying to correct nipple confusion. But breastfeeding is not just about feeding your child food, there is much more to consider than just the nutritional factors. The benefits of breastfeeding, other than nutrition, are all linked to breastfeeding, including giving your child a sense of security and confidence, preventing finger-sucking, fetishism and oral fixation, helping toddlers recover from frustration more quickly to explore, and so on. The value of breastfeeding is tremendous after 1 year of age, while bottle-feeding is of very little value after 1 year of age. Because 2/3 of your baby’s nutrition comes from meals after the age of 1 year, as long as the diet is well-matched, the nutrition is balanced and comprehensive enough. Moreover, there is no opportunity cost for breastfeeding after 1 year of age. Bottle-feeding does not have to wait until the age of 1. It starts to consume the time that the mother could have used to accompany, observe and help her child from the first day. Especially after the child is able to crawl and walk, there is a lot of activity and exploration that requires adult help. If the mother has to go to work and has limited time to spend with her child, every minute spent on the breast pump is a high opportunity cost. So, don’t fixate on bottle-feeding as a temporary stopgap in extraordinary circumstances as a daily feeding routine. Mothers should not be short-sighted, but take a long-term view. Does nipple confusion affect breastfeeding? Some health professionals believe that breastfeeding problems such as sore nipples and rejection can be caused by nipple confusion, because the theory is that nipple confusion can cause a breastfed baby to take milk in other ways. Therefore they advocate that in order to avoid such problems, babies should not be allowed to take milk from a bottle. However, these conditions can occur even in babies who have never used a bottle, so it doesn’t make sense to blame it all on the bottle. As a rule of thumb, many of the problems blamed on nipple confusion can be solved by teaching mothers how to get their babies to hold their nipples properly. Some babies do find it difficult to take the breast, but this can be due to many reasons. Often it is simply because no one is encouraging them to suckle properly, they may need more practice, or their mother may need expert help so that the baby can eat well and happily. Occasionally, a baby may have a problem like a short tongue tie, which can make it hard for him to breastfeed. Or the mother’s breast tissue may be very hard, making it difficult for the baby to suck on the nipple. Both of these conditions are not the same thing as nipple confusion. In breastfeeding rash, if the baby has a hard time holding the nipple and sucking properly on the mother’s breast, the doctor will help the mother express the breast milk and give it to the baby in a bottle, but the problem still has to go away. We always tell mothers what to do to encourage their babies to open their mouths wide and wrap their tongues down and forward (just like they do with breast milk) around the teat, so that they do this every time they breastfeed. We advocate that babies take their own mother’s milk, but we would rather have the mother temporarily give her baby the expressed breast milk in a bottle than struggle to first feed from a cup and then have to wean off the breast milk altogether. The former approach gave us time to work out breastfeeding issues. I’ve never met a baby who wouldn’t take milk from the mother’s breast just because she took the expressed breast milk in a bottle. Solutions to nipple confusion Many mothers have no choice but to continue to bottle feed simply because they have not mastered the correct method of correcting nipple confusion, allowing the wrong method and the desperation of no progress to drag themselves and their families down. Correct nipple confusion as early as possible: the younger your baby is and the shorter the time you have been using the bottle, the easier it is to correct nipple confusion. There is no more choice than to stop using the bottle and use a small spoon feed until the baby reaccepts the mother’s nipple, or the “finger feeding method” or whatever is acceptable to the baby, other than the bottle. Pre-feeding stimulation: The biggest reason babies with nipple confusion reject their mother’s nipples is because they don’t feel that it’s as fast and easy as taking a bottle. Therefore, the mother can stimulate the milk showers before feeding, so that the baby can take a big mouthful of breast milk as soon as he or she takes the nipple. To do this, relax and think of your baby’s cute face as he or she eats, gently pinch the nipple with your washed fingers and turn it from side to side and touch the front of the nipple from time to time. When your breasts feel itchy, your breasts become hard, your nipples are moist, and when you gently squeeze them, milk will squirt out, it means that the milk shower is coming. Pick up your baby and feed him/her as soon as possible. The milk shower stimulation method is also helpful when you use a breast pump to pump milk. It is best to try breastfeeding when your baby is not too hungry and in a good mood: this way your baby will have more patience to try for a while longer. Some parents think that by starving the baby, the baby will eventually have to breastfeed. This is wrong. A hungry baby will not have the patience to explore the technique of sucking on the mother’s nipple. The mother can hold the baby and play with it, let the baby get close to the breast, and then naturally bring the nipple to the baby’s mouth. Don’t breastfeed suddenly, don’t force feed, and don’t try to breastfeed too often. This will make your baby hate the breastfeeding thing even more. Help your baby learn to wait: Your baby doesn’t refuse to suck on your mother’s nipple and will use the correct breastfeeding and sucking position to eat breast milk, but he or she just doesn’t understand that mother’s milk is produced one milk burst at a time, unlike milk from a bottle that can be gobbled up until it is gone. Therefore, when one milk burst passes and the next one does not come, she cannot wait patiently while sucking and will spit out the nipple and cry. There are two things a mother can try at this point. One is to pick up the baby and tease him or her, and then feed him or her when the mood improves. The second is to use a feeding aid to slowly release the milk between the two milk bouts to “retain” the baby to continue sucking in order to stimulate the next milk bout. Important principles to solve nipple confusion 1. Stop using the bottle immediately and firmly, and the bottle must be stopped completely. Try breastfeeding when your baby is not hungry, using a small spoon or finger feeding method when your baby is hungry, or using a feeding aid to assist with breastfeeding. In short, don’t use a bottle. Many mothers don’t want to see their babies annoyed and crying, and once they get crying they take out the bottle again. Such an approach teaches the baby that he or she must cry to get the bottle and that if he or she insists on crying and insists on not eating the breast, the mother will definitely give the bottle. Many mothers claim to have corrected this for a month or more, with adults and children suffering, but never succeeding, because they did not stop using the bottle completely. The mother must remember that if she does not completely stop the bottle and take it out from time to time to use it when the baby cries, it is artificially prolonging the baby’s confusion and making the baby suffer more torment. 2. Increase the amount of milk. Mothers of babies with confused nipples are usually troubled by “insufficient milk”. The lack of stimulation from the baby’s sucking at the nipple areola makes it normal for the milk to not come up. The less milk you have, the less your baby will want to eat. The more your baby doesn’t eat, the less milk you get. In addition to correcting the baby’s nipple confusion, it is also imperative for the mother to increase her milk supply. If the baby refuses to suck on the mother’s nipple, the mother can use a breast pump to simulate the baby’s sucking and increase the stimulation of the nipple areola, thus increasing the amount of milk. You can suckle once an hour and a half to two hours instead of waiting until the milk rises. If the baby is able to suck on the mother’s nipple at least sometimes, it is better for the mother to chase the milk without a breast pump. Instead, use a feeding aid and just hold the baby in your arms for a few days to feed her hard. This will give the best results. If the baby doesn’t cooperate, the mother should use the breast pump as often as possible in addition to breastfeeding. The milk from the breast pump can then be supplemented by a feeding aid. Babies with confused nipples will cry when they can’t eat their beloved bottle. The mother or other family members should allow the baby to express her displeasure by crying, but also give comfort gently and lovingly, and be firm and optimistic about the correction plan. It is inappropriate to panic at the sight of a crying baby, to hold the baby anxiously, or even to change your mind about it. Although some mothers are incredibly resilient in sucking out and bottle-feeding their babies until they are a year old or even longer, the effort and inconvenience involved is enormous. More often than not, babies whose nipple confusion is not corrected end their happy days of breastfeeding early.