Many breastfeeding parents worry about bottle and nipple confusion. Is nipple confusion a real concern or should it be called the nipple confusion myth? Let’s start by understanding it.
What Is Nipple Confusion?
This term has been used to describe a baby who is primarily feeding at the breast that may become acclimated to bottle feeding and therefore, will not be able to feed directly at the breast. It has also been used to describe confusion between pacifiers and the breast. There is probably more evidence to support nipple confusion as it relates to bottles and less to that of pacifier use, although there is not very strong evidence for either.
Should breastfeeding moms worry about switching between the bottle and the breast?
The answer is it depends. Each baby is unique and there are certain bottles you can purchase that are less likely to cause your baby to prefer the bottle over the breast. Some of this depends on the shape of the bottle while much of it also depends on the flow. Because breastfeeding is more challenging for the newborn, slow flow bottles are a good option while establishing breastfeeding. If your baby begins to realize that the bottle is much easier to get food from, they may prefer the bottle. They are not “confused” about which to choose. They are very much aware that the bottle is easier and therefore may cry for it.
Here are our recommendations when it comes to the best bottles for breastfed baby:
Slow Flow Nipple & Ultra Slow Flow Nipple
Slow flow nipples are a great choice when it comes to breastfed babies. This type of nipple and bottle will mimic the flow of the milk that comes out of the breast and are less likely to make your newborn prefer the bottle over the breast. Some of these, however, maybe so slow that a hungry baby may become very frustrated. Be sure to look out for hunger cues in your baby so that you can have a bottle prepared and ready to go. Typically, your baby will feed every 2 to 3 hours so you can prepare yourself according to this schedule. Certain brands have different levels of flow and this can be very helpful in deciding which level makes the most sense for your baby. Extra slow flow is a good place to start and increase the level of flow from there if needed.
Breast Shaped Bottle
Some brands make bottles that are shaped like the breast. In the beginning, when your baby is too young to hold the bottle, this does not matter much. As they get older and can hold the bottle themselves, it may be a nice bottle to have. There is no real evidence to support that a breast shaped bottle is better than one that is not, but there is no harm in using one either.
Combo Slow Flow Nipple And Bottle Shaped Like Breast
Related: 5 Essential Breastfeeding Tips
A very small number of brands carry a combination of slow flow nipples and bottles that mimic the breast. This specific Tommee Tippee bottle is also a great option for babies who have colic as it does also have an anti-colic valve. Remember, that there is a lack of high-quality scientific studies on colic treatment. So, it is unclear if these anti-colic valves are actually helpful, so purchase with a grain of salt.
Best Bottles For Breastfed Babies: Take Home Points
Although there is little evidence to support that nipple confusion is a real problem, choosing a bottle that encourages breastfeeding is likely a good choice. Slow flow nipples and slow flow bottles can be helpful to encourage feeding at the breast as can bottles that are shaped and feel like the breast. The recommendations linked above a good place to start!
Zimmerman E, Thompson K. Clarifying nipple confusion. J Perinatol. 2015 Nov;35(11):895-9. doi: 10.1038/jp.2015.83. Epub 2015 Jul 16. PMID: 26181720.
Zeevenhooven J, Browne PD, L’Hoir MP, de Weerth C, Benninga MA. Infant colic: mechanisms and management. Nat Rev Gastroenterol Hepatol. 2018 Aug;15(8):479-496. doi: 10.1038/s41575-018-0008-7. PMID: 29760502.
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