Nipple Confusion
Nipple confusion or flow preference can sometimes be the cause of a whole range of breastfeeding problems, and often prevention can be the cure.
Giving your baby a dummy or bottle in their first few weeks of life can lead to confusion. This is because the way your baby sucks on your breast is very different to the way he or she would suck on a bottle or dummy.
To milk your breast your baby will hold your nipple very far back in his or her mouth while the gums squeeze the milk ducts under the areola, with tongue moving rhythmically from front to back milking the areola and the nipple.
Often to milk a bottle, your baby doesn't need to move his or her tongue. Simply moving their gums up and down is enough to allow gravity to do the rest and make the milk flow from the bottle. The milk doesn't need to be drawn out of a bottle, as it does from your breast. Often the teets of bottles and dummies are shapped nothing like a breast and will sit in your baby's mouth in a different position than your breast would.
When put to the breast, babies who have been given a bottle soon after birth may look like they are pushing the nipple out of their mouths and will probably suck only the tip of the nipple. The same type of "tongue in front" sucking is used when sucking on a dummy.
Babies can also become used to the fast and immediate flow of the bottle and can become frustrated if they have to wait for a let down. Often this may lead to breast refusal and supply problems.
Nipple confusion can also lead to very painful breastfeeding as your baby may chomp down on the tip of your nipple, as they would do when bottle feeding. The pain you feel may make having a let down more difficult, making it tempting –and understandably so– to give your frustrated, crying baby another bottle instead. You can see how easily it can become a cycle.
If your baby is having trouble attaching to your breast may lead to cracked nipples, engorgement, and possibly mastitis, depending on how much milk your body is making and how much is being removed from your breasts.
Over a short time these breastfeeding problems may be likely to sway you into giving your baby another bottle…which may in turn lead to a drop in your milk supply, and in many cases permanent bottle feeding.
What can you do??
• If you are having problems with your baby's attachment and feel that there may be some nipple confusion, lots of skin to skin contact can help.
• You can try breastfeeding your baby before they are overly hungry and offer them the breast often.
• Expressing for your own comfort and to keep your milk supply up may help you to start breastfeeding again when the phase has passed.
• You can also try hand expressing just before offering your breast to your baby so that your milk has started flowing for your baby and they don't have to work to make it happen.
• Seek help from a family health nurse or lactation consultant that can support you through this.
Breastfeeding is something we learn to do with our babies. It can take time and patience. Go easy on yourself and focus on the wonderful bond you have with your baby, this will help the both of you.
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