What is Nipple Confusion? It is a problem that arises when a breastfed baby is given an artificial (rubber or silicon) nipple and must try to learn to nurse both from his mother's breast and the bottle nipple. While seemingly similar, these two feeding methods require completely different mouth and tongue motions and swallowing skills.
In breastfeeding, the baby needs to take as much of the nipple and areola into his mouth as possible to 'pump' the milk from the milk ducts. In bottle feeding, he uses his lips to grip the tip of an artificial nipple. Some nipples do better to imitate a natural breast, but none are quiet the same.
In breastfeeding, the baby must place his tongue beneath the nipple and use it to help create the 'vacuum' needed for nursing and to pump and swallow the milk. In bottle feeding, the baby must place his tongue in front of the nipple and uses it to stop the flow of milk while he swallows.
In breastfeeding, the baby removes milk from the breast by a combination of sucking and pumping the milk from the milk ducts. When the baby stops sucking and pumping, the milk stops flowing. In bottle feeding, the milk flows fairly readily from the nipple once an initial suction is created and then the baby simply controls the flow by placing his tongue over the holes in the nipple.