Breastfeeding issues, Part 1:
Nipple confusion is defined as “an infant’s difficulty in achieving the correct oral configuration, latching technique, and suckling pattern necessary for successful breast-feeding after bottle feeding or other exposure to an artificial nipple.” Although there is inconsistent evidence to support this topic, many practitioners believe that after exposure to artificial nipples (such as bottles or pacifiers), infants experience difficulty with breastfeeding. The main cause for debate is limited research as to whether bottles and pacifiers are causing infants to refuse the breast or if it’s simply markers of maternal-infant characteristics.
Studies have shown that the way a baby latches to his or her mother’s breast is very different than the way they suck on a bottle or pacifier. Bottle feeding can separate the epiglottis and soft palate connection. It elevates the soft palate, drives the tongue back and alter the action of tongue. This makes it difficult for the baby to drink milk and may result in fussiness or frustration from the infant. It can also be an explanation to why babies may have trouble switching back and forth between drinking from a bottle and breastfeeding.
Another hypothesis that can explain nipple confusion include:
1. The newborn may have a limited ability to adapt to various oral configurations.
2. A form of “imprinting” may happen when the baby receives a bottle before the breastfeeding attempt.
3. Low colostrum available with breast-feeding in the first few days of life.
4. An infant who has not learned to grasp and suckle the nipple correctly might perceive bottle feeding as easier and more rewarding.
Methods that can be considered or used to help feeding and prevent nipple confusion, until breast-feeding can be established, include: a cup, spoon or dropper or the use of nipple shields. Many other issues can cause breastfeeding challenges, such as tongue/lip tie, TMJ weakness and missing/weak primitive reflexes. We will cover these in future blogposts. Working with a pediatric chiropractor is always a good idea, and a lactation consultant can help identify if your child’s fussiness or difficulty feeding is related to nipple confusion.
RFC’s Breastfeeding Service Recommendation:
Angela Gomes dos Santos, CLC
National Lactation Consultant website: