Nipple confusion in neonates

Breastfeeding is influenced by social factors, some of which motivate women to seek additional feeding solutions, including feeding formula milk or expressed breastmilk (EBM) by bottle. Anecdotal evidence Indicates that some women offer bottles of EBM during and after the establishment of breastfeeding and continue to breastfeed successfully. The World Health Organization (WHO) recommends that breastfed infants should not be offered artificial teats during the establishment of breastfeeding. This is due to concerns regarding nipple confusion. This article confirms that the evidence supporting nipple confusion is inconclusive and that other issues such as supplementation with formula milk can lead to problems labelled as nipple confusion. Breastfeeding advice advocated by WHO may not meet the needs of all breastfeeding women and prescriptive advice from health care professionals may lead to early cessation of breastfeeding which is avoidable. Midwives should be flexible in their approach to breastfeeding and take women's individual needs into account.