Breast, teat or bottle: how to avoid confusion?

What is breast-feeding confusion?

For the young parents of a breastfed infant, breast-nipple confusion is a legend. Accused of almost all ills, but above all of complicating and even terminating breastfeeding, it could occur at the introduction of the bottle or, more rarely, the Pacifier. "Confused" babies would then refuse to continue breastfeeding and would only accept the bottle.

In fact, from a physiological point of view, the link between bottle-feeding and disrupted breastfeeding has never been established. Instead, the confusion between breast and nipple is thought to stem from the infant's difficulty in latching on to the breast, leading to a preference for the bottle. The word "confusion" is therefore particularly ill-suited to the phenomenon.

How do I know if my baby is affected by breast-nipple confusion?

There's nothing easy about identifying breast-nipple confusion. First and foremost, it's a matter of pinpointing a sucking disorder in infants, babies or very young children. In practice, what adults call "breast-nipple confusion" manifests itself in different ways in children.

• Baby gets upset at the breast, cries, seems to refuse to breastfeed.
• He is unable, or no longer able, to take the breast properly, which he takes and releases, takes and releases, or pinches, which can be painful.

These reactions can also be a sign of GERD (gastroesophageal reflux disease), infant colic, hidden pain or discomfort. If observing your baby isn't enough to put you on the right track, consult your GP or paediatrician. If you don't already know them, you can also contact theassociation of lactation consultants, who can help you.

What if it was all a question of milk flow?

Because bottle-feeding and breast-feeding are two very different things, just as some babies prefer breast milk to infant milk, others may develop a preference for the faster flow of bottle-fed milk. This can happen, for example, in cases of moderate lactation. Despite his efforts to suckle, the baby receives less milk from the breast than from the bottle, and may therefore prefer the latter.

Breast-nursing confusion: where does it come from?

The origin of breast-nipple confusion is specific to each baby, his birth and his history. However, it seems that the most common causes are not directly linked to the introduction of a pacifier, but rather to :

• a lack of tongue mobility caused by a brake, particularly in the upper lip,
• tensions created during pregnancy or childbirth, leading to stiffness in the tongue, mouth or even head,
• a difficulty in coordinating sucking and swallowing,
• prematurity,
• a drop in breast milk production, etc.

Breast-feeding confusion: what are the consequences?

Sucking: an essential role for babies

Among the archaic reflexes present from birth is sucking. Acquired in utero, this ability is used for feeding, relaxation and much more.

• With each feeding, the sucking mechanism changes the intracranial pressure, which modulates the shape of the skull of babies whose bones (temporal, sphenoid and ethmoid in particular) are not fused at birth. The palate, too, develops to allow the proper placement of teeth and the evolution of the respiratory tract.
• Sucking also accompanies the development of the maxillae and many facial muscles, and alone influences part of the physiognomy.
• When babies suckle, they need to breathe through their nose. This form of breathing is the most effective for oxygenating the brain and activating the vagal system linked to relaxation.

Solutions for your baby

Getting back to the basics of breastfeeding

Once you've identified the source of the confusion, don't hesitate to start breastfeeding again from scratch (or almost). Offer your baby the breast often, day and night, but without insisting. You can also compress your breasts a little to accentuate the expression of your mother's milk, and do this in a quiet place, alone with your baby.

Imagining alternatives to baby bottles

It's a little-known fact, but there are several ways of giving milk to a baby. Depending on the age of the infant or child, they are more or less familiar and accessible.

• The Lactation aid (DAL) prevents the use of teats.
• The oral syringe squirts milk directly into baby's mouth from the sides.
• The soft cup, spoon or bottle cup, enables older babies to drink by sucking up the milk. With the baby's need to suck unsatisfied, latching on becomes easier.
• The glass or cup, in a seated position from 6 months.

Renewing the bottle-nipple duo