Re: is nipple confusion or flow confusion a concern? where is the research

[Guest guest]

I don't believe there is such a think as nipple confusion. If you want to know more about my thoughts, there is some info on my website. just search "nipple confusion." Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:00 PM

I know an IBCLC who uses a lot of bottles when EBM or formula supplements are offered.

She does not believe that standard pre prepared formula nipples or other nipples will interfere with breastfeeding.

Demonstrating cradle hold fast bottle feeding in the presence of the family, does that interfere with teaching breastfeeding to parents of a newborn.

Is there research or documentation to justify using cup vs SNS vs bottles in the early days.

I have searched for several hours on line but have not found anything that states the need for SNS/ CUP vs an artificial nipple.

I appreciate any information pro or anti artificial nipples!

[Guest guest]

I personally have seen many babies who nursed well at birth and some dr said they needed formula because *gasp* baby lost a small amount of weight in the first few day PP (probably due to inflated fluid levels from IVs). Then these babies refused to breastfeed. Now setting up the conditions necessary to make nursing successful got baby back to the breast, but really I think it's best to avoid artificial nipples for the first few weeks if possible because moms will often not seek help and will give up breastfeeding because they feel rejected by their baby. If it isn't possible a good lactation helper (to include LCs LLL WIC etc) can help these babies to breastfeed. Obviously if moms had expert help from the get go she could introduce a bottle in a way that won't cause a problem, but I see too many issues to say it doesn't exist and they aren't better off avoiding artificial nipples if possible. Now my son switched from bottle to breast from birth without any issues until he refused bottles at 3 months of age (I ended up canceling a surgery because of it). I think the point is that introducing artificial nipples early on can cause problems for some babies, but with help those babies can return to the breast. It isn't the end of breastfeeding if the mom has access to help and seeks it out when needed. Heinz, BA IBCLCBeach Babies Lactation Support, LLC Sender: Date: Tue, 20 Dec 2011 19:08:19 -0800 (PST)To: < >ReplyTo: Subject: Re: is nipple confusion or flow confusion a concern? where is the research I don't believe there is such a think as nipple confusion. If you want to know more about my thoughts, there is some info on my website. just search "nipple confusion." Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:00 PM I know an IBCLC who uses a lot of bottles when EBM or formula supplements are offered.She does not believe that standard pre prepared formula nipples or other nipples will interfere with breastfeeding.Demonstrating cradle hold fast bottle feeding in the presence of the family, does that interfere with teaching breastfeeding to parents of a newborn. Is there research or documentation to justify using cup vs SNS vs bottles in the early days.I have searched for several hours on line but have not found anything that states the need for SNS/ CUP vs an artificial nipple.I appreciate any information pro or anti artificial nipples!

[Guest guest]

I hear that all the time. But did you actually see those babies breastfeed who were supposedly feeding well at the breast? when I hear those stories it has always been the case that the babies actually weren't feeding well, which is why there was weight loss/sore nipples/whatever that caused the bottle to be introduced in the first place. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- On Tue, 12/20/11, Heinz

wrote:Subject: Re: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:23 PM

I personally have seen many babies who nursed well at birth and some dr said they needed formula because *gasp* baby lost a small amount of weight in the first few day PP (probably due to inflated fluid levels from IVs). Then these babies refused to breastfeed. Now setting up the conditions necessary to make nursing successful got baby back to the breast, but really I think it's best to avoid artificial nipples for the first few weeks if possible because moms will often not seek help and will give up breastfeeding because they feel rejected by their baby. If it isn't possible a good lactation helper (to include LCs LLL WIC etc) can help these babies to breastfeed. Obviously if moms had expert help from the get go she could introduce a bottle in a way that won't cause a problem, but I see too many issues to say it doesn't exist and they aren't better off avoiding artificial nipples if possible. Now my son switched from bottle to breast

from birth without any issues until he refused bottles at 3 months of age (I ended up canceling a surgery because of it). I think the point is that introducing artificial nipples early on can cause problems for some babies, but with help those babies can return to the breast. It isn't the end of breastfeeding if the mom has access to help and seeks it out when needed. Heinz, BA IBCLCBeach Babies Lactation Support, LLC

Sender:

Date: Tue, 20 Dec 2011 19:08:19 -0800 (PST)To: < >ReplyTo:

Subject: Re: is nipple confusion or flow confusion a concern? where is the research

I don't believe there is such a think as nipple confusion. If you want to know more about my thoughts, there is some info on my website. just search "nipple confusion." Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:00 PM

I know an IBCLC who uses a lot of bottles when EBM or formula supplements are offered.

She does not believe that standard pre prepared formula nipples or other nipples will interfere with breastfeeding.

Demonstrating cradle hold fast bottle feeding in the presence of the family, does that interfere with teaching breastfeeding to parents of a newborn.

Is there research or documentation to justify using cup vs SNS vs bottles in the early days.

I have searched for several hours on line but have not found anything that states the need for SNS/ CUP vs an artificial nipple.

I appreciate any information pro or anti artificial nipples!

[Guest guest]

Your right since I don't work in a hospital I didn't see these babies nursing prior to a bottle being given. However for the mom who is so etched in my mind her baby lost only 5% and when I saw her she seemed to have technique down. The baby just wasn't willing to suck at the breast. We took away the bottles and syringe fed him and he was nursing fine with no pain within 24 hours. He regained birth weight by a week of age (only got the two bottles of formula dr demanded before allowing baby to be discharged - the rest was all EBM). I think there is a big problem, at least in my area, of interventions being done in the hospital and the staff there never seeing this mother/baby pair again and not knowing what happens after they leave. I'm the one who has the mom crying on the phone with me once she's home and making emergency visits to fix what would have been a simple latch issue that has now become a nightmare of shields, a dozen bottles and pacifiers galore. I even had an OB recently call me after being given a shield by the hospital IBCLC who, for whatever reason, never noticed the mom was trying to nurse the baby with the baby on her back (and yes she saw her in person, actually two of the LCs that work there). I left her thinking "geez if a dr can't get basic instruction from the hospital she works at what hope do the rest of the moms have."And even if these babies weren't nursing well from the start wouldn't it be better to instruct them on how to nurse effectively and check for TT before moving to a bottle? There is no reason (at least in my area of the world) why every baby can't have someone who knows what they are doing help their mommies out on day one. (Says the IBCLC who lives in an area with an abundance of PP IBCLCs and a dozen hospitals who are understaffed, but won't hire us). Heinz, BA IBCLCBeach Babies Lactation Support, LLC Sender: Date: Tue, 20 Dec 2011 19:40:10 -0800 (PST)To: < >ReplyTo: Subject: Re: is nipple confusion or flow confusion a concern? where is the research I hear that all the time. But did you actually see those babies breastfeed who were supposedly feeding well at the breast? when I hear those stories it has always been the case that the babies actually weren't feeding well, which is why there was weight loss/sore nipples/whatever that caused the bottle to be introduced in the first place. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:23 PM I personally have seen many babies who nursed well at birth and some dr said they needed formula because *gasp* baby lost a small amount of weight in the first few day PP (probably due to inflated fluid levels from IVs). Then these babies refused to breastfeed. Now setting up the conditions necessary to make nursing successful got baby back to the breast, but really I think it's best to avoid artificial nipples for the first few weeks if possible because moms will often not seek help and will give up breastfeeding because they feel rejected by their baby. If it isn't possible a good lactation helper (to include LCs LLL WIC etc) can help these babies to breastfeed. Obviously if moms had expert help from the get go she could introduce a bottle in a way that won't cause a problem, but I see too many issues to say it doesn't exist and they aren't better off avoiding artificial nipples if possible. Now my son switched from bottle to breastfrom birth without any issues until he refused bottles at 3 months of age (I ended up canceling a surgery because of it). I think the point is that introducing artificial nipples early on can cause problems for some babies, but with help those babies can return to the breast. It isn't the end of breastfeeding if the mom has access to help and seeks it out when needed. Heinz, BA IBCLCBeach Babies Lactation Support, LLC Sender: Date: Tue, 20 Dec 2011 19:08:19 -0800 (PST)To: < >ReplyTo: Subject: Re: is nipple confusion or flow confusion a concern? where is the research I don't believe there is such a think as nipple confusion. If you want to know more about my thoughts, there is some info on my website. just search "nipple confusion." Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:00 PM I know an IBCLC who uses a lot of bottles when EBM or formula supplements are offered.She does not believe that standard pre prepared formula nipples or other nipples will interfere with breastfeeding.Demonstrating cradle hold fast bottle feeding in the presence of the family, does that interfere with teaching breastfeeding to parents of a newborn. Is there research or documentation to justify using cup vs SNS vs bottles in the early days.I have searched for several hours on line but have not found anything that states the need for SNS/ CUP vs an artificial nipple.I appreciate any information pro or anti artificial nipples!

[Guest guest]

I believe there is both nipple confusion and nipple preference.

If baby can't get milk from the breast and is always hungry, then gets a bottle nipple and for once, wow, his tummy is finally full, you bet he's gonna *prefer* the nipple that fills his tummy.

But I have worked with many mothers who did not have enough milk in the beginning and so used a bottle with a wide base and short nipple shaft to offer supplement. Nothing physically wrong in baby to cause an improper suck. But after getting supplemented for a couple weeks (it usually takes them that long to find me, or maybe decide to pay my fee) with a less-than-ideal nipple shape which *did* fill the baby's tummy, baby now comes to breast with a tight mouth because that tight mouth on the wide-based nipple finished filling up his tummy, so he got confused. When I had mother switch to a narrow-based nipple that could fit entirely in baby's mouth, so that he had to suck on the bottle nipple with a suck much closer to a proper breastfeeding suck, within 1-2 days, baby would be sucking better at breast, and mom's pain would lessen.

JHL issue from Feb 2002 has an article about cup feeding showing that a lot of the milk actually ended up in baby's bib and the babies often got exhausted and quit feeding when they had received only 15 ml or less of milk. While cup feeding may not cause nipple confusion, it also doesn't teach babies how to suck properly. And babies need to suck, so I am uncomfortable with cup feeding for ongoing supplementation.

I feel we are opening ourselves up to possible legal trouble if we don't make absolutely sure the baby has a proper breastfeeding suck before suggesting tube feeding. Tube feeding rewards *any* suck, even a suck improper for breastfeeding. And it reinforces that incorrect suck by filling baby's tummy. I have lost count of the number of babies who come to me being tube fed but can't get a drop from the breast because the tube has rewarded baby's improper suck. If baby has a proper suck and mother doesn't have enough milk for some reason, then I think tube feeding can be an appropriate method of supplementation, so that mother can do the whole feeding at breast and doesn't have to spend time pumping afterwards.

Dee Kassing

I know an IBCLC who uses a lot of bottles when EBM or formula supplements are offered.She does not believe that standard pre prepared formula nipples or other nipples will interfere with breastfeeding.Demonstrating cradle hold fast bottle feeding in the presence of the family, does that interfere with teaching breastfeeding to parents of a newborn. Is there research or documentation to justify using cup vs SNS vs bottles in the early days.I have searched for several hours on line but have not found anything that states the need for SNS/ CUP vs an artificial nipple.I appreciate any information pro or anti artificial nipples!

[Guest guest]

yes, it would be great if moms got the help they need so alternative methods of feeding were not needed! and I'm in the same position as you...cleaning up messes and no hospital here will even consider hiring IBCLC's that aren't also RN's. but in 20 years, I have never seen a baby confused by an artificial nipple. I've seen babies refuse the breast when it's not working for them, for sure. And also seen them have trouble on day 3-4 when mom explodes from all those fluids with labor. But I don't think they're confused. They just need the underlying problem fixed..then they will breastfeed.Today I saw a 5 day old baby whose mom said had been breastfeeding mostly with a too-small nipple shield (that was hurting her) but that she was able to get him on the bare breast for about 15 min a few times. she

was convinced that the nipple shield and early bottles were making things difficult for him. when we tried him at the breast today, he opened wide, and seemed to take the breast and suck. Mom said that's what he had done with her. He was sucking on his T'ONGUE! He had me fooled for a bit. Once he latched with a larger shield and she saw him suck and swallow, mom said OOOOHHHH! He's never sucked like that before! I just don't think babies are confused. I don't believe we can take 1000's of years of hard-wired infant mammal behavior and mess it up with an artificial nipple. We sure can make it difficult for them, though, with all of our "advanced" technologies!Respectfully... Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:23 PM

I personally have seen many babies who nursed well at birth and some dr said they needed formula because *gasp* baby lost a small amount of weight in the first few day PP (probably due to inflated fluid levels from IVs). Then these babies refused to breastfeed. Now setting up the conditions necessary to make nursing successful got baby back to the breast, but really I think it's best to avoid artificial nipples for the first few weeks if possible because moms will often not seek help and will give up breastfeeding because they feel rejected by their baby. If it isn't possible a good lactation helper (to include LCs LLL WIC etc) can help these babies to breastfeed. Obviously if moms had expert help from the get go she could introduce a bottle in a way that won't cause a problem, but I see too many issues to say it doesn't exist and they aren't better off avoiding artificial nipples if possible. Now my son switched from bottle to breast

from birth without any issues until he refused bottles at 3 months of age (I ended up canceling a surgery because of it). I think the point is that introducing artificial nipples early on can cause problems for some babies, but with help those babies can return to the breast. It isn't the end of breastfeeding if the mom has access to help and seeks it out when needed. Heinz, BA IBCLCBeach Babies Lactation Support, LLC

Sender:

Date: Tue, 20 Dec 2011 19:08:19 -0800 (PST)To: < >ReplyTo:

Subject: Re: is nipple confusion or flow confusion a concern? where is the research

I don't believe there is such a think as nipple confusion. If you want to know more about my thoughts, there is some info on my website. just search "nipple confusion." Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:00 PM

I know an IBCLC who uses a lot of bottles when EBM or formula supplements are offered.

She does not believe that standard pre prepared formula nipples or other nipples will interfere with breastfeeding.

Demonstrating cradle hold fast bottle feeding in the presence of the family, does that interfere with teaching breastfeeding to parents of a newborn.

Is there research or documentation to justify using cup vs SNS vs bottles in the early days.

I have searched for several hours on line but have not found anything that states the need for SNS/ CUP vs an artificial nipple.

I appreciate any information pro or anti artificial nipples!

[Guest guest]

What about the special needs feeder?

What are your experiences with those?

Would they ever be a good choice for a baby without a cleft palate?

BTW I love your webpage. I could spend hours reading your post.

Warmly

Elaine Rose IBCLC

Sent from my, very fine line between " hobby " and " mental illness " , iPhone.

[Guest guest]

Wow, Elaine, that's the nicest compliment! Thank you! Let me know if there's anything you'd like to be there but isn't. I'm learning!I don't have a lot of experience with haberman feeders, if that's what you're referring to. If a baby needs an alternate feeding method, I always try to find a way that is most efficient and effective for baby and for parents. Sometimes it's a tube at the breast and sometimes it's a bottle. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: is nipple confusion or flow confusion a concern? where is the researchTo: " " < >Date: Tuesday, December 20, 2011, 9:17 PM

What about the special needs feeder?

What are your experiences with those?

Would they ever be a good choice for a baby without a cleft palate?

BTW I love your webpage. I could spend hours reading your post.

Warmly

Elaine Rose IBCLC

Sent from my, very fine line between "hobby" and "mental illness", iPhone.

[Guest guest]

As I read it I can easily imagine you sitting right in front of me talking.

It's really great.

I can never remember what they call that bottle, now. I supported a mom as a

leader a few years back, the Ibclc told her to use that bottle so her baby would

learn to suck. I never understood why she said that. That baby never went

back to the breast.

Warmly

Elaine

Sent from my, very fine line between " hobby " and " mental illness " , iPhone.

[Guest guest]

Oh, amen to this too........again all of it.

beth

ottawa

To: From: second9months@...Date: Tue, 20 Dec 2011 21:06:11 -0800Subject: Re: is nipple confusion or flow confusion a concern? where is the research

yes, it would be great if moms got the help they need so alternative methods of feeding were not needed! and I'm in the same position as you...cleaning up messes and no hospital here will even consider hiring IBCLC's that aren't also RN's. but in 20 years, I have never seen a baby confused by an artificial nipple. I've seen babies refuse the breast when it's not working for them, for sure. And also seen them have trouble on day 3-4 when mom explodes from all those fluids with labor. But I don't think they're confused. They just need the underlying problem fixed..then they will breastfeed.

Today I saw a 5 day old baby whose mom said had been breastfeeding mostly with a too-small nipple shield (that was hurting her) but that she was able to get him on the bare breast for about 15 min a few times. she was convinced that the nipple shield and early bottles were making things difficult for him. when we tried him at the breast today, he opened wide, and seemed to take the breast and suck. Mom said that's what he had done with her. He was sucking on his T'ONGUE! He had me fooled for a bit. Once he latched with a larger shield and she saw him suck and swallow, mom said OOOOHHHH! He's never sucked like that before!

I just don't think babies are confused. I don't believe we can take 1000's of years of hard-wired infant mammal behavior and mess it up with an artificial nipple. We sure can make it difficult for them, though, with all of our "advanced" technologies!

Respectfully...

Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.

Subject: is nipple confusion or flow confusion a concern? where is the researchTo: Date: Tuesday, December 20, 2011, 7:00 PM

I know an IBCLC who uses a lot of bottles when EBM or formula supplements are offered.She does not believe that standard pre prepared formula nipples or other nipples will interfere with breastfeeding.Demonstrating cradle hold fast bottle feeding in the presence of the family, does that interfere with teaching breastfeeding to parents of a newborn. Is there research or documentation to justify using cup vs SNS vs bottles in the early days.I have searched for several hours on line but have not found anything that states the need for SNS/ CUP vs an artificial nipple.I appreciate any information pro or anti artificial nipples!

[Guest guest]

weird...about that ibclc. and i'm so glad you like the blog! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: is nipple confusion or flow confusion a concern? where

is the researchTo: " " < >Date: Tuesday, December 20, 2011, 9:49 PM

As I read it I can easily imagine you sitting right in front of me talking.

It's really great.

I can never remember what they call that bottle, now. I supported a mom as a leader a few years back, the Ibclc told her to use that bottle so her baby would learn to suck. I never understood why she said that. That baby never went back to the breast.

Warmly

Elaine

Sent from my, very fine line between "hobby" and "mental illness", iPhone.