Does my baby have nipple confusion?

Breastfed babies use different feeding and swallowing skills than bottle-fed babies. When breastfed babies are given artificial nipples before their breastfeeding skills are fully developed, they may experience nipple confusion. The best way to avoid nipple confusion is to avoid bottle nipples and pacifiers until the baby has learned to breastfeed well, about the first 4–6 weeks of age.

But just because artificial nipples and bottles were given to your baby doesn’t mean that you have to give up on breastfeeding altogether. Here are a few things you can try:

  • Ditch the pacifier. Discontinue using pacifiers, and make sure any caregivers do the same. 
  • Prep the breast. Massage your breast and pump or hand-express a little bit of milk before trying to latch your baby onto your breast. That way, your milk will be immediately available to your baby, and there won't be a delay between when he latches on to the breast and when your milk lets down.. 
  • Be consistent. Offer your breast often and early, whenever your baby shows early signs of hunger (restlessness, head movements, eye movements, mouth motions, hand-to-mouth activity, soft murmuring). 
  • Check the latch. Don’t let your baby latch on to your nipple; make sure she takes your entire nipple and as much of your areola (the darker part of the breast around the nipple) as possible into his mouth. If she doesn’t latch well, slip a finger being her lips and your breast to break the latch, and try again.

If you need professional help, seek out an international board-certified lactation consultant (IBCLC) or talk with your baby’s health care provider or a La Leche League Leader. And remember to be patient. Some babies are champion feeders from the start, but many others take some time to learn how to breastfeed. Your patience can help make all the difference.

Last updated May 18, 2020

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