Introducing a bottle to your baby can be a challenging decision. Whether it's due to medical reasons, lifestyle choices, or the need for flexibility, every family's journey is unique. Some babies need supplementation if they are not gaining enough weight 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 feel anxious about introducing a bottle, especially if they hope to continue breastfeeding in the long term. Some babies have plans of their own - some resist taking a bottle, while others may take to it so well that they lose interest in the breast. The term “nipple confusion” is a popular but controversial term for this phenomenon. There are different views on nipple confusion, and some professionals frame it as bottle or flow preference. Read on to learn more about the term “nipple confusion”, why it is referred to in different ways and how you can avoid running into these challenges.
Understanding Nipple Confusion
Nipple confusion occurs when an infant has trouble transitioning between bottle feeding and breastfeeding. Infants may fuss, struggle to latch or refuse to breastfeed after being introduced to an artificial nipple. This is because of flow differences between bottle and breast, and the type of suckling effort needed to extract milk. Bottle feeding requires very little effort, similar to drinking with a straw. Breastfeeding requires much more effort, because it engages all the oral muscles and this gives baby control over the flow. Additionally, the firm sensation of an artificial nipple on the roof of the mouth is very different from mom's soft and pliable nipple, and your baby can develop a preference based on this alone.
How to Avoid Nipple Confusion
Once you understand these differences between breast and bottle feeding, you can work out the best way to introduce bottle feeding. You will often hear that it is helpful to establish breastfeeding before introducing a bottle, when possible. As well as protecting your milk supply, this helps the baby get used to the effort needed to extract milk. It also keeps them in a natural and healthy feeding routine, getting just what they need. When introducing bottles to exclusively breastfed babies, use a slow flow feeding system - test the bottle before using it as flow rates vary between brands. Emulait bottles stand out from the crowd because they feature the unique Emulait Responsive Flow Valve, which helps baby to control the pace of their feed as they would at the breast by releasing milk according to the strength of baby’s suckle. This feeding innovation relieves parents of all the guesswork around flow upgrades and changing nipples. 
For babies who have used other bottles, transitioning to a system like Emulait may take some practice. As with any new skill, practice and persistence are key to success and so is good support!
Finally, for babies who need bottles from the get-go, give them a head start with Emulait. If you are expecting a baby via surrogate or have had medical issues which will require you to bottle feed your baby, plan ahead and pop one in your hospital bag!
If your baby prefers bottle to breast, there are a few things you can do to help them:
- Make sure that you keep pumping to maintain your milk supply while encouraging baby “back to the breast” or learning how 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.
- Bring a prepped bottle to the feeding session. Think of it as a tool to keep a baby calm while working on a successful latch. Start by offering the bottle or use it intermittently if your baby starts to get frustrated. If the baby is too distressed, be patient and follow their cues.
- Correct positioning can make a huge difference. Usually, a few adjustments are all it takes. Seek professional support if you are having trouble with latching.
- 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 mimics the flow that babies who breastfeed are used to. The soft nipple will also be more familiar to them.
- Mimic the reclining position that baby relaxes into when breastfeeding. Thanks to the Responsive Flow Valve, baby stays in charge of the pace, and also gets the interpersonal benefits of a responsive feed.
- Use positive bottle association. Offer the bottle with room temperature milk and warm the nipple under a tap. If baby averts their head or thrusts the nipple out, keep a positive face and tone.
- Feeding times are an opportunity to develop mutual communication skills, as promoted by responsive feeding. Let baby know that you are in sync with them and if they refuse, take it as a “not now” from baby. Stay as positive as you can.
- Distract your baby with a short play or 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!
“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
Whether you call it nipple confusion or flow preference is less important. Understanding why it happens can help you achieve your combination feeding goal. Be patient with yourself and your baby as you figure it out. Choosing the right bottle is also critical. Finally, seek professional guidance if you feel overwhelmed or uncertain about your progress. Emulait also offers in-house lactation support to our customers – reach out! We’re here on this journey with you.
