RE: Re: is nipple confusion or flow confusion a concern?

[Guest guest]

so back from my consult with baby #3 this week who had been on bottles while mom healed - of course this one didn't have the good supply the others had but baby went to breast and yes, baby acted confused ('where is my long firm super stimulus silicone nipple thing??!! wha wha"") but again with a mom who is willing, patient and has good help and support (if I don't say so myself) and the addition of compression and switch nursing baby got on and drank. So it isn't that babies don't get 'confused' it is just that they can get unconfused once good support is available to sort out underlying issues.......they often seem soooo relieved afterwards, like "thank heavens!". some of them take longer - i've definitely worked with them too! got lucky this week 3 back at breast fairly easily (tho will likely need some follow up of course). maybe i got 3 of those 'suck on anything' babies......... so maybe i 'believe' in confusion too I just think they can be fixed/taught (usually).

beth ba ibclc lllc leader

ottawa

To: From: IBCLC@...Date: Wed, 21 Dec 2011 08:17:14 -0800Subject: Re: is nipple confusion or flow confusion a concern?

AH yes near and dear to me since I deal with this all the time. Love all the responses – and will throw in my own two (or three) cents. J

Some babies will suck on anything – it can be the breast, the worst bottle on the market, the best bottle – whatever. It just doesn’t matter. They will not deal with confusion (which I do believe in and I’ll explain that in a minute.) nor will they deal with nipple preference (when they prefer that which feeds them faster – be it breast or bottle). Other babies can have problems from the first introduction of a nipple other than the moms breast – whether it be finger feeding, cup feeding, another woman’s breast or some type of bottle nipple. Others if they never have a chance to breastfeed at all deal with imprinting on that which feeds them – that is why we want them to breastfeed first…imprint on the breast – NOT an artificial nipple, cup or tube on a finger.

I look at Nipple Confusion like this: (btw – I am a Car Chick – so use these analogies a lot and my parent’s ‘get it’!)

The standard (any brand any type) bottle nipple is an Automatic Transmission. All you have to do when you get into that car is put the car in drive and steer. You don’t even have to put your foot on the gas pedal – it will move forward on it’s own. (standard bottle nipples will flow without any suction and many cause babies to drink or drown – kind of like my car when I showed my <disbelieving> son that it would do this – on a flat stretch of road with no gas pedal contact got itself up to 15mph and shifted into 2nd gear! Maybe I should have that looked at!) You can, with some effort, drive an Automatic transmission sort of like a Manual by starting in 1st gear, moving to 2nd and then finally dropping into Drive – it is not particularly easy on the car and you have to really know what you are doing or you will overly wind up that engine. I liken this to be kind of like Paced Feeding. J If you don’t know what you are doing, you can overly stress the baby who is having issues – you have to know how to do it, what to watch for and how to keep things moving smoothly for the baby without overwhelming the – engine. J

The Breast is a Manual Transmission (stick shift) – with a touchy clutch. You MUST coordinate the clutch, the gas pedal, the stick shift and the steering wheel in order to drive your car. Mess up any one of the first three and you have a problem – you aren’t going anywhere or you are not going there comfortably! (who remember bunny hopping the car down the road when first learning to drive a stick?? Or even just killing the engine!!) Sore nipples, trauma, etc come from baby not knowing how to use that Manual tranny too well. J

Some people can move between manual and automatic transmissions seamlessly (the baby who doesn’t care what they suck on). Others (like myself) need a few days to adjust fully (when I had to trade out my stick for and automatic it took me 3 wks to stopping hitting the brake trying to use it as a clutch!) or develop a preference for that which is easier (automatic) and never go back to the manual… (that would not be me! I much prefer the manual…)

Babies need something that is as similar to breastfeeding mechanics as possible. Personally I have found the Breastflow Bottle to be quite helpful in many situations - not–all, but many. I look at this bottle as the equivalent of a stick shift with a really soft clutch – which means you can let the clutch out too fast or slow and still not kill the engine or bunny hop the car. However, if you are a savvy clutch driver (like I was) you can literally shift gears without using the clutch for the most part! This would be that baby who, regardless of what needs to be done, uses the Breastflow improperly and does not suckle the way they should – they compensate and thus no help is given by the bottle (I switch them out to a different nipple if they do this)

Babies with suck issues, tight muscles, tongue-tie etc. may very well have difficulties with their Manual Transmission as their coordination skills may not be up to par with what the breastfeeding actually requires. (kind of like trying to drive a manual tranny with a broken left foot…push that clutch in - ouch!) We need to correct the problem first while working with them on that practice for driving that manual…

The trick (or skill) is to know HOW to correctly set that baby up for being able to ‘drive the manual’ by teaching them how to do so with the ‘soft clutch’ (Breastflow) or Automatic (with Paced feeding techniques or whatever works). The (so-called) LC who does not believe in nipple confusion and bottle feeds every baby with a regular nipple in a cradle position should have her IBCLC revoked in my opinion. The information is absolutely out there to show this is not OK and it can definitely cause far more problems for that baby and the breastfeeding. If that baby has a serious suck-swallow issue, that type of feeding can cause a myriad of health and emotional issues for the baby and can ruin breastfeeding for a very long time – if not permanently.

So – there is my two or three cents on this topic. Like I said, I deal with this one ALL the time…my parents laugh at the analogies but they ‘get it’ and that is what counts. It helps them focus on helping their babies learn to ‘drive that manual!!’ while using the automatic (or soft clutch).

Warmly,

Jaye

[Guest guest]

I love you analogy Jaye. if you don't mind I'm going to use that with the moms I help. It makes it much clearer to them (especially dads I'm sure). I see issues with nipple confusion/preference all the time. Sometimes bottles have to be used and I don't doubt that. We all want that baby fed. But I so often see it added instead of helping the mom with latch. Heinz, BA IBCLCBeach Babies Lactation Support, LLC Sender: Date: Wed, 21 Dec 2011 08:17:14 -0800To: < >ReplyTo: Subject: Re: is nipple confusion or flow confusion a concern? AH yes near and dear to me since I deal with this all the time. Love all the responses – and will throw in my own two (or three) cents. J Some babies will suck on anything – it can be the breast, the worst bottle on the market, the best bottle – whatever. It just doesn’t matter. They will not deal with confusion (which I do believe in and I’ll explain that in a minute.) nor will they deal with nipple preference (when they prefer that which feeds them faster – be it breast or bottle). Other babies can have problems from the first introduction of a nipple other than the moms breast – whether it be finger feeding, cup feeding, another woman’s breast or some type of bottle nipple. Others if they never have a chance to breastfeed at all deal with imprinting on that which feeds them – that is why we want them to breastfeed first…imprint on the breast – NOT an artificial nipple, cup or tube on a finger. I look at Nipple Confusion like this: (btw – I am a Car Chick – so use these analogies a lot and my parent’s ‘get it’!) The standard (any brand any type) bottle nipple is an Automatic Transmission. All you have to do when you get into that car is put the car in drive and steer. You don’t even have to put your foot on the gas pedal – it will move forward on it’s own. (standard bottle nipples will flow without any suction and many cause babies to drink or drown – kind of like my car when I showed my <disbelieving> son that it would do this – on a flat stretch of road with no gas pedal contact got itself up to 15mph and shifted into 2nd gear! Maybe I should have that looked at!) You can, with some effort, drive an Automatic transmission sort of like a Manual by starting in 1st gear, moving to 2nd and then finally dropping into Drive – it is not particularly easy on the car and you have to really know what you are doing or you will overly wind up that engine. I liken this to be kind of like Paced Feeding. J If you don’t know what you are doing, you can overly stress the baby who is having issues – you have to know how to do it, what to watch for and how to keep things moving smoothly for the baby without overwhelming the – engine. J The Breast is a Manual Transmission (stick shift) – with a touchy clutch. You MUST coordinate the clutch, the gas pedal, the stick shift and the steering wheel in order to drive your car. Mess up any one of the first three and you have a problem – you aren’t going anywhere or you are not going there comfortably! (who remember bunny hopping the car down the road when first learning to drive a stick?? Or even just killing the engine!!) Sore nipples, trauma, etc come from baby not knowing how to use that Manual tranny too well. J Some people can move between manual and automatic transmissions seamlessly (the baby who doesn’t care what they suck on). Others (like myself) need a few days to adjust fully (when I had to trade out my stick for and automatic it took me 3 wks to stopping hitting the brake trying to use it as a clutch!) or develop a preference for that which is easier (automatic) and never go back to the manual… (that would not be me! I much prefer the manual…) Babies need something that is as similar to breastfeeding mechanics as possible. Personally I have found the Breastflow Bottle to be quite helpful in many situations - not–all, but many. I look at this bottle as the equivalent of a stick shift with a really soft clutch – which means you can let the clutch out too fast or slow and still not kill the engine or bunny hop the car. However, if you are a savvy clutch driver (like I was) you can literally shift gears without using the clutch for the most part! This would be that baby who, regardless of what needs to be done, uses the Breastflow improperly and does not suckle the way they should – they compensate and thus no help is given by the bottle (I switch them out to a different nipple if they do this) Babies with suck issues, tight muscles, tongue-tie etc. may very well have difficulties with their Manual Transmission as their coordination skills may not be up to par with what the breastfeeding actually requires. (kind of like trying to drive a manual tranny with a broken left foot…push that clutch in - ouch!) We need to correct the problem first while working with them on that practice for driving that manual… The trick (or skill) is to know HOW to correctly set that baby up for being able to ‘drive the manual’ by teaching them how to do so with the ‘soft clutch’ (Breastflow) or Automatic (with Paced feeding techniques or whatever works). The (so-called) LC who does not believe in nipple confusion and bottle feeds every baby with a regular nipple in a cradle position should have her IBCLC revoked in my opinion. The information is absolutely out there to show this is not OK and it can definitely cause far more problems for that baby and the breastfeeding. If that baby has a serious suck-swallow issue, that type of feeding can cause a myriad of health and emotional issues for the baby and can ruin breastfeeding for a very long time – if not permanently. So – there is my two or three cents on this topic. Like I said, I deal with this one ALL the time…my parents laugh at the analogies but they ‘get it’ and that is what counts. It helps them focus on helping their babies learn to ‘drive that manual!!’ while using the automatic (or soft clutch). Warmly,Jaye