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Thread: Is this nipple confusion?

  1. #1

    Default Is this nipple confusion?

    FTM here. My baby is 2-month old. She has had no trouble breastfeeding since day 1, and her weight is in the 90th percentile, so we've never been concerned with her latch or my milk supply. She's been using the pacifier and has used a few bottles (pumped breast milk) since she was just a week old. I've never had problems switching between bottle and my breast until yesterday. At first I thought she was on a nursing strike. She refused to latch - whenever I put my breast beside her mouth, she would scream bloody murder. After an entire day of this, I figured out that she will easily take a pacifier so I'd have to remove the pacifier from her mouth then immediate put my nipple near her, this kind of tricked her into latching on my breast so she can eat again. I've been doing this for 3 feedings now (each time, I've tried giving her my nipple directly, which she refused to take). My question is, is this a nursing strike or nipple confusion? (Or something more serious?) What can I do to break this new habit of hers?

  2. #2
    Join Date
    Jun 2009

    Default Re: Is this nipple confusion?

    Hi and welcome!

    I do not think anyone can be sure if your baby's breast refusal is definitely due to the pacifier and bottle use. But if there is no apparent physical issue (teething or earache pain, overall illness, or something like that) then I think it is a strong possibility. Sometimes milk flow (too fast or too slow) might cause a baby to pull off, but it would be kind of unusual for a flow issue to cause a baby to not want to latch in the first place. Possible? Maybe.

    One of the huge misconceptions about bottle and pacifier use is the idea that if they are going to cause a problem with breast refusal, the problem will be evident more or less immediately. But that is not how it works at all. The earlier and longer a baby gets bottles and pacifiers, the more likely they will cause this kind of problem over time. Many moms will find baby "switches back and forth just fine" - until one day they do not. Of course, the frequency of bottle and pacifier use is going to have an impact on this as well.

    Obviously bottles are breast substitutes and consequently cause breast refusal in some cases. But pacifiers are often overlooked although they can be even more troublesome, because when baby is given a pacifier instead of nursing, baby is trained away from seeking the breast for comfort. Breastfeeding is never only about the food, comforting at the breast is a huge part of it and if that is reduced and baby is given a substitute too often, it can certainly cause or exacerbate a breast refusal problem. Together, bottles and pacifiers can be so problematic in causing breast refusal it has it's own name: "triple nipple syndrome."
    Confusing the issue, of course, is that many babies are given pacifiers and bottles frequently from early on and never refuse to nurse. So this is by no means a universal issue but is a common one.

    Another common factor in breast refusal is sleep training and/or meal scheduling, or baby not being encouraged to nurse to sleep or nurse for comfort or to nurse overnight. This is one reason why cue feeding is emphasized as so important for breastfed babies -even when they do get bottles some of the time.

    All a nursing strike means is baby is refusing to nurse for some reason. Although a classic strike usually occurs with babies who are much older than this, you can call this a strike if you like. It does not really matter because the cure in any case is the same, and that is to gently and persistently encouraging baby to nurse again for both comfort and food, and if baby is refusing to nurse with normal frequency, (8-12 times in 24 hours) and you are needing to supplement, making sure to pump or hand express frequently enough to keep milk production in great shape. It would also probably help to reduce or eliminate bottles at this time- if you can. Obviously if baby is truly refusing to nurse you may need to give baby milk in a bottle (or some alternative) here and there. If that is so, you might try using paced bottle feeding technique. See: http://www.llli.org/docs/00000000000...astfedbaby.pdf

    While you also will want to try to avoid using the pacifier for comforting, if the "pacifier switch trick" is working for you in getting baby to nurse that is a good idea to keep trying. There are also many other ways to encourage a baby who is refusing to nurse to nurse and you may want to try as many as make sense to you- repeatedly, if necessary. This article describes just about every strategy in this area: http://kellymom.com/ages/newborn/nb-...ack-to-breast/

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