What is Nipple Confusion and How to Resolve It

Tips and strategies to avoid nipple confusion for your baby when both bottle feeding and nursing.

When you’re a breastfeeding mom, necessity may dictate that baby gets your breast milk in a bottle, but sometimes difficulties such as nipple confusion can occur if a baby is both breast and bottle-feeding. Understanding why nipple confusion happens and using strategies to ease the transition between breast and bottle can help lessen or avoid this for your little one.

What is Nipple Confusion and Why Does it Happen?

Nipple confusion is when a breastfeeding baby is having trouble latching and breastfeeding effectively after being fed with a bottle.

It can occur because babies need to use different techniques when nursing versus feeding from a bottle. When breastfeeding, they control the flow of milk from mom by creating suction, using their pauses to swallow and breathe. When using an average baby bottle, babies don't have to work as hard because gravity and the nipple cause the milk flow to be more continuous for baby. Nipple confusion occurs when baby switches back to breast, and doesn't understand why the milk flows differently than it did with the bottle.

Strategies to Help With Nipple Confusion

  • Since there’s no way to predict if your little one will struggle with nipple confusion, it’s recommended to delay giving a bottle or pacifier until breastfeeding is well established – usually when your baby is about 4 weeks old.
  • If your baby is getting more bottles once you return to work or school and your milk supply might be lower, he may prefer the quick flow of the bottles. You can work on reversing this by trying to increase your milk supply and focusing on more breastfeeding time.

  • Another type of nipple confusion occurs when baby refuses bottles and only wants to breastfeed. Practice offering bottles in a relaxed, low-key way and stop if your baby becomes fussy or stressed. Or, try switching it up and having someone else give the bottle. Some babies will not accept a bottle from mom, but will accept a bottle from a family member or caregiver.

  • Look into using a bottle system that mimics babies’ natural breastfeeding motions and behavior to make the transition from bottle to breast easier. Keep a copy of current breast milk storage guidelines (also available in Spanish!) on hand, so you can store and freeze any pumped milk correctly and safely.

If you find that you and your baby are continuing to struggle over nipple confusion, reach out to a Lactation Consultant who can work with you and guide you through this challenge. It will take some effort to make the transition from bottle to breast easier for your little one, but it’s worth it to help get your breastfeeding journey back on track and going strong!