Breast/Bottle/Teat Confusion

Breastfeeding is a natural process that requires specific coordination of sucking, swallowing and breathing in the baby. However, the introduction of a pacifier or bottle can sometimes disrupt this process, leading to what is commonly referred to as “breast/pacifier confusion.” Although, it is not the most appropriate term. Indeed, the child is intelligent enough to see and feel the difference. The suction is also totally different.

This article explores this phenomenon, its causes, its manifestations and the means to prevent it.

What is breast/pacifier “confusion”?

Breast/pacifier confusion refers to the difficulty some babies experience alternating between the breast and bottle. The sucking techniques required for drinking from the breast and from a bottle are different: at the breast, the baby must open his mouth wide and use rhythmic sucking to extract the milk, while at the bottle, the milk flows on its own and requires less sucking. ‘Effort. It’s a bit like giving our child a glass of water, choosing the pace for them.

Causes and manifestations

1. Differences in sucking technique: Breast sucking involves complex coordination of the tongue and jaw muscles to create negative pressure and extract milk. In contrast, a bottle nipple allows milk to flow more freely, often with less effort, which can disrupt a baby’s natural sucking.
2. Flow differences: The flow of milk from the bottle is generally faster and constant, unlike at the breast where the flow can vary and sometimes requires additional effort to initiate the flow (ejection reflex). This stronger flow from the bottle causes oxygen desaturations and the baby therefore goes into orthosympathetic mode (under adrenaline because it is perceived as a danger, an insecurity)
3. Signs of confusion: Signs of breast/pacifier confusion may include:
   • Difficulty latching on.
   • Frustration or restlessness during feeding.
   • Ineffective suction or poor latch.
   • Marked preference for the bottle.

Prevent breast/pacifier “confusion”

1. Establish solid breastfeeding before introducing the bottle: There is no need to immediately want to get your baby used to learning to take a bottle. This can be done a few days before the community release. It is recommended to wait until breastfeeding is well established, generally after 6 weeks, before introducing a bottle. This helps ensure that the baby has developed an effective sucking technique at the breast.
2. Use alternatives to bottle feeding: If supplementation is necessary, consider other feeding methods such as cup, syringe, or finger feed. These methods can minimize the risk of confusion by more closely mimicking breast sucking technique.
3. Choose slow flow teats: If using a bottle is unavoidable, opt for a slow-flow teat similar in shape to the breast to encourage more natural sucking and avoid overwhelming the baby with too fast a flow. The ideal is a round, long, flexible pacifier with a narrow base.
4. Use the paced bottle feeding technique

The bottle is placed horizontally, the teat is not filled with milk, just halfway, so it is the baby who decides the rhythm of the feeding. You can take breaks by lowering the bottle, switching sides in the middle of the bottle. Don’t hesitate to pay attention to your baby’s signs of comfort. This will allow you to adapt the pace, identify moments when baby needs a break…

Think about other containers that are more respectful of baby’s sucking.

Management of breast/pacifier “confusion”

1. Getting back to the basics of breastfeeding: If the baby seems to have difficulty resuming the breast after taking a bottle, it is crucial to return to the basics of breastfeeding: correct positioning, good latch, and frequent feedings. Skin-to-skin contact can also help restore effective breastfeeding.
2. Assess and treat sucking problems: In most cases, difficulty resuming the breast is a sign of previously undetected sucking problems. It is important to consult a lactation consultant to evaluate the baby’s sucking technique and identify possible problems. In some cases, sucking retraining exercises may be necessary to help the baby regain effective sucking at the breast.
3. Change container, use a more suitable container. Consult.
4. Persevere with patience: The transition from bottle to breast can take time and patience. Encourage and praise the baby for each progress, and try to maintain a calm and relaxed attitude during feedings.

Conclusion

The baby’s sucking difficulties can complicate breastfeeding. By understanding its causes and implementing preventive and corrective strategies, mothers can help their babies maintain effective sucking at the breast and fully benefit from the benefits of breastfeeding. For any persistent difficulties, it is essential to consult a lactation professional for personalized and adapted support.