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Troubleshooting Breastfeeding Part 2: Nipple Confusion


Breastfeeding is a learned process that can take time to establish. Sometimes it takes a bit of persistence and troubleshooting. In our last article we emphasized learning a proper latch and avoiding artificial nipples. In this article we will discuss what to do if your baby develops nipple confusion.  


Nipple Confusion

Nipple confusion happens when your baby is exposed to artificial nipples such as a pacifier, bottle nipple or a nipple shield. Artificial nipples work very differently than breast nipples and a baby under 6 weeks of age can easily get them confused. This will often result in frustration for you and your baby. Babies who find comfort in a pacifier or are bottle fed will often expect a breast nipple to work and feel the same as an artificial one. Breastfeeding is a more complicated process than expressing milk from a bottle nipple, where the milk is free flowing. If he has gotten used to a bottle, your baby may get frustrated at the work he has to do to cause milk to flow from your breast.   

Artificial nipples will also encourage your baby to develop bad habits when it comes to nursing. A nursing baby must open their mouth wide and place their tongue forward over their bottom jaw to properly latch on. Nipple confused babies often forget how to do this and refuse to open wide or stick their tongue forward. Latching on without these components is often painful for you and ineffective for you baby. This may also cause a disruption in milk supply as nipple confused babies have trouble expressing milk properly.  


Fixing Nipple Confusion:

Once a baby has developed nipple confusion, it may take quite a bit of retraining and work on your part to help him learn to properly latch. Consistency is the key. Start by helping your baby to open very wide. Press your finger gently down on his chin so that he opens wide. Mimic this by opening your mouth wide and saying “open wide.”

Look to see that your baby’s tongue is down and forward and then try to latch him. Once latched on, have a helper check the position of your baby’s tongue by lightly moving the lower lip to see if the tongue is visible above your baby’s lower gums. If it is not visible, try the following and then practice re-latching.  

If your baby is having trouble with the mechanics of opening his mouth and brining his tongue forward and down, use your clean pinky finger to help him. Place your pinky in your baby’s mouth, on his tongue. Gently pull your baby’s tongue forward and over his lower gums as he sucks on your finger. Practice this motion several times and then attempt to latch your baby back onto the breast.

The process of fixing nipple confusion will take time. With persistence, you can teach your baby to latch onto your breast properly. If you are experiencing trouble in your breastfeeding relationship, don’t lose hope. With a little help and some effort on your part, you should be able to establish a good nursing routine. For more resources see:

For more information on troubleshooting breastfeeding see Troubleshooting Breastfeeding Part 1 and 3.

The Womanly Art Of Breastfeeding I can’t recommend this book enough. All women breastfeeding or preparing to breastfeed need to have a copy of this book. It has everything you will need to successfully breastfeed.

La Leche League Website This is a great resource for all breastfeeding mothers.   

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