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Dazed and Confused Babies? The truth about Nipple Confusion...

Posted Apr 23 2008 12:00am
Baby Friendly? The pacifier can be a powerful tool to help infants with feeding disorders. Our bias gets in the way of intelligent treatment plans. Medical research helps clarify garbage pail terms like 'nipple confusion.' A term like that tells me nothing as a feeding specialist about what is going on. Feeding Aversion is the same. Children are not aversive to all food, just foods outside their sensory systems tolerance level. Define a problem and use the tools you have to help infants, use a pacifier as a treatment tool, not a plug. Be wise and don't be fooled by rules that do not make sense.

Pacifiers are actually encouraged during gavage feedings and use results in better GI transit time, an increase in fat breakdown and better weight gain.
Pacifiers also calm an infant and result in better state and organization and less energy expenditure.
Nipple confusion is a broad term that does not encourage the therapist to define what is occurring with the infant or the mother
Medical research defines two types of “nipple confusion”
Type A refers to the infant’s difficulty in exhibiting the correct oral configuration, latching technique and suckling pattern necessary to extract milk from the breast after exposure to an artificial nipple.
Typically this occurs when the artificial nipple is introduced before the successful establishment of breast-feeding. It is most likely to occur due to differences in flow rate. Type A is the infant who successfully bottle feeds but has difficulty breastfeeding.
Type B refers to the older infant who is proficient at breast-feeding and then refuses the bottle. This is actually “bottle refusal” instead of nipple confusion.
It can also describe infants who turn to the bottle and then start to refuse the breast. This may actually be related to decreased maternal milk supply or lack of interest in nursing.
The notion that a single bottle will result in breast-feeding failure runs contrary to experience.

Studies to support: Cronenwett, et al, in a study of 121 breastfeeding couples found that single daily bottle use had no significant impact on duration of successful breastfeeding.
Study: (Neifert, Lawrence and Seacat) There is no research that shows using a pacifier with a preterm infant interferes with breastfeeding.
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