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Chủ Nhật, 6 tháng 12, 2015

Nipple confusion - what it is and how to avoid it

Feeding from a breast is very different to feeding from a bottle, or comfort sucking on an artificial nipple (dummy/pacifier or bottle teat). The 'sucking' motion is different, and feeding from a bottle requires less work on the baby's part. If a baby is given an artificial nipple then they may learn this different way of sucking, and try to apply it when breast feeding. This is called nipple confusion. It is much easier to stop nipple confusion from occurring in the first place than to try and rectify the situation later on.

Often a baby who is nipple confused will not open their mouth wide enough to take in a sufficient amount of the areola (the pink/brown circle at the base of the nipple) and end up sucking on the nipple alone; this is painful for the mother, and can lead to sore or bleeding nipples, and results in poor let down as the baby's tongue is not sufficiently massaging the breast and milk ducts. This can in turn lead to frequent feeding, gradual loss of milk supply and poor weight gain as the baby will receive less fat rich hind milk.

A baby who is nipple confused may also become upset at the breast (or even refuse it) as the milk may be coming less slowly than from a bottle. The best way to avoid nipple confusion is not to offer an artificial nipple, especially during the first 6 weeks. It is recommended that no supplements (either formula/artificial baby milk or expressed breast milk) are offered during the first 6 weeks as this period is crucial to establishing a good supply of breast milk. Alternatives to using a bottle That sounds fine in theory, but there are times when it is not possible to follow the 'best practice' advice - so what can you do?

If you need to give your baby expressed milk (or artificial baby milk) then you should know that it does not have to be from a bottle. Babies can drink milk (or expressed colostrums - the yellowish antibody and calorie laden first 'milk') from a spoon, a sterile eye dropper, a syringe, a cup (there are infant cups especially designed for this purpose) or a lactation aid - a tube attached to the breast by the nipple, leading to a reservoir (bottle or bag) of milk, or by finger feeding.

The method of feeding which you chose to feed your baby expressed milk or artificial baby milk will depend on the situation and what method you have available. Most houses will have a teaspoon or a shot glass which could be used to feed the baby, and these work well as an emergency stand by. In hospitals syringes are readily available, and most maternity units will also lactation aids and or cups available - However many hospitals will assume that baby is to be fed expressed milk or artificial tops by bottle, so it is important that you make it clear that you do not want your baby to have any sort of artificial nipple - writing it on your birth plan is a good start, but you may need to re-iterate it.

If you need to give top ups on the basis of medical advice, or if you are giving them because of suspected low milk supply, then a properly used lactation aid may be the best idea, as this provides breast stimulation and can help to increase milk supply. Replying to well intentioned advice Well intentioned advice from people who are not familiar with breast feeding can be very hard to deal with. Most mothers are fine with politely rejecting advice from strangers and acquaintances, but it cam be harder to ignore advice from friends and family. Here are some pieces of advice which you may get , and some ways to respond, or things to bear in mind:

Just one bottle wouldn't hurt It might not, but then again, especially if baby is less than 6 weeks old, that might be all it takes to confuse him/her Dad needs to give baby a bottle so that they can bond He doesn't need to give baby a bottle - there are plenty of other ways in which he can bond and support breastfeeding. That doesn't mean that Dad just gets the nasty jobs (nappy changing), but many dads like to bath or massage their baby, which give plenty of skin to skin contact or hold their baby while he/she sleeps or falls asleep.

Dads can also be great at holding a baby with colic - often lying face down along a forearm calms a colicky baby, and Dads are much better at that (as they have nice strong arms). Dads also support breastfeeding in lots of ways - obvious ones like getting Mum a drink and less obvious ones like unconsciously protecting mum's space. You are spoiling baby by letting him/her suck for comfort. Give him/her a dummy instead One of the most important things that a mum can do is provide comfort to their child - you'd better get used to it as you will probably be comforting your child in one way or another for the rest of your life.

Many women prefer to talk about nursing, rather than breastfeeding as they know that breastfeeding is about much more that supplying a baby's nutritional needs. All babies need to suck, some more than others, and there is nothing wrong, and everything right, with baby satisfying this need in mum's arms. If it is all getting a bit much, then letting baby suck on a finger - clean of course - is better than offering a dummy.

Not all babies will suffer from nipple confusion - some will go happily from breast to bottle; but the problem is that you can't tell whether your baby will until it is too late and there is a problem. If your baby is nipple confused, then it is important that you remove the source of confusion as quickly as possible, and speak to a trained breastfeeding counselor for advice and support.

Note on cup feeding. Babies do not 'drink' from a cup in the same way as an adult does. Instead they 'lap' from milk held to their lips, rather like a cat. Do NOT pour milk into baby's mouth as this can cause choking Please be aware that the information given in these articles should in no way be taken as a substitute for professional advice.

If you have questions or concerns regarding your, your family's or your child's physical or mental health, please seek other professional assistance. We cannot be held responsible for any damages that result from the use of the information provided on Breast Feeding and Baby Wearing. Any statements and opinions expressed on Breast Feeding and Baby Wearing are those of the author and do not necessarily reflect the opinions of Breast Feeding and Baby Wearing. All information and designs on these web pages are copyright of Breast Feeding and Baby Wearing and may not be used or reproduced without our written permission.

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