As with much of parenthood, the decision to introduce a bottle to a feeding routine is not always straightforward. This decision is highly personal and can stem from any number of reasons. Some babies need supplementing if they are not gaining weight at a thriving rate or have other medical issues. Some mothers experience medical conditions that impact their ability to produce milk or exclusively breastfeed. Other families want or need the flexibility that a bottle provides. Lifestyle or cultural factors can play a part in this decision too.
Many parents have concerns and even fears about this process, especially when they want to sustain breastfeeding long-term. And some babies seem to have their own plans too! If you are confused about introducing a bottle or your baby is struggling with the transition between breast and bottle, this blog will explain what the term “nipple confusion” means, why it is sometimes referred to in different ways and how you can avoid running into these challenges.
What is nipple confusion?
Nipple confusion occurs when an infant has trouble transitioning between bottle and breast. Infants may fuss, struggle to latch, or refuse to breastfeed after being introduced to an artificial (hard silicone) nipple. This is linked to differences in the flow rate of the bottle and the type of suckling effort needed to remove the milk, along with the clear differences between standard bottle nipples and a mother’s anatomy. The firm sensation of an artificial nipple on the roof of the mouth is vastly different from a soft and pliable human nipple, as is the experience of extracting milk.
How to avoid nipple confusion
If you want to combine breastfeeding and bottle feeding in a way that supports long-term breastfeeding, you should be aware that babies who are introduced to the hard silicone teats of conventional bottles may find it harder to return the breast. The material over-stimulates baby’s sucking reflex. For this reason, it is always recommended to establish breastfeeding before introducing a bottle. For exclusively breastfed babies, use a slow flow feeding system. Test the bottle before using it as flow rates vary between brands. Fill the bottle with liquid and hold it upside down - if it drips out easily, the flow rate will be too fast for baby. If you intend to use the Emulait feeding system, do your best to make it the first bottle you try with your baby. Babies who have been using other bottles can learn to use Emulait’s bottles, however there will be a learning curve as they learn how to latch onto the softer nipple and re-master the skills needed to control the flow. As with most things in life – practice makes perfect (as does good support – you can reach out to Emulait’s in-house lactation expert for help with this process).
If your baby prefers bottle to breast, there are a few things you can do to help them:
- Make sure you keep pumping to maintain your milk supply while finding a way to encourage baby “back to the breast” or to combination feed effectively.
- Follow your baby’s early hunger cues - a frustrated baby will find it harder to latch on to your breast. It may be useful to do a quick hand expression session or pump to trigger your let-down reflex.
- Come to the feeding session with a bottle ready. Look at it as a tool to keep baby calm while working on a successful latch. Offer it at the beginning of the feed or intermittently if baby starts to grow frustrated and make a point of not letting baby get too upset.
- Getting the breastfeeding position right can make a huge difference. Get hands on support in the first 2 weeks if latching is not getting easier. A few adjustments are usually all it takes and the earlier the better, as baby develops their own opinion rapidly after a few weeks!
- Try to make feeding sessions relaxed and enjoyable for both of you.
If your baby prefers breast to bottle, there are a few things you can do to help them:
- Enlist your partner or another caregiver to introduce the bottle to your baby.
- Use a bottle like the Emulait Anatomy bottle, which mimics the shape, feel and function of a real breast - and features a suitable flow for babies who are used to breastfeeding. The soft nipple will also be more familiar to them. Some babies do not like the hard silicone of conventional teats initially (and for some, this stimulation is what makes it irresistible). Try to mimic your breastfeeding setup - keep it warm and cuddly, with good eye contact, and correct positioning.
- Use positive bottle association. Offer the bottle with room temperature milk, warm the nipple under a tap, and if baby averts their head or thrusts the nipple out keep a positive face and tone. Let baby know that you are in sync with them and if they refuse, take it as a “not now” from baby – feeding times are an opportunity to develop mutual communication skills, as promoted by responsive feeding.
- Distract your baby with a short play or a change of scenery before offering them the breast to prevent building a cycle of bottle refusal leading to a breastfeed.
- Take a break if you aren’t making progress - stress and pressure will only make it harder for both you and your baby
- View any progress as success! Remind yourself that you and baby are on this feeding journey together, and that it is about finding a groove that works. This can take time!
Confusion about nipple confusion
You may have heard mixed messages about nipple confusion. There are different views on nipple confusion, and some professionals frame it as bottle or flow preference. This is a reference to the ease with which babies can feed from a bottle which has a faster flow and which requires less effort from them. Suckling at the breast requires a baby to “work” - the mechanics for this should come naturally to most babies, even if it takes some practice and support from a lactation consultant. However, babies sometimes have a mind of their own - and this can start at the breast! There are babies who refuse the breast once an artificial bottle has been introduced, and there are babies who completely refuse bottles.
“Once babies have had something that they're very familiar with, they may show a preference. One of the reasons we adore and are so excited about the Emulait system is because it doesn't give the baby an option to have a preference - the baby is going to be taking a bottle that is as close to or almost identical to its own mother's breast during the breastfeeding experience”.
Linda M. Hanna, Lactation and OB Expert, Member of Emulait’s Scientific Advisory Board
In summary
Lactation consultants and your health professional can help you with tips and techniques for effective breastfeeding and the best way to introduce a bottle. This is a common challenge, and it may take some time to figure out what works for you and your baby. At Emulait we have used innovative thinking, technology and materials to create a first-of-its-kind bottle. Our bottles mimic the shape, feel and function of a real breast to offer your baby the milk flow of a real breast and emulate the feeding process. You can learn more about our science-driven process and the bottle features on our website. Emulait also offers in-house lactation support to families learning how to maximize the Emulait feeding experience.
