So - called nipple confusion can occur when a baby is offered the breast, the bottle, and/or a pacifi er within a brief time frame. Breast - feeding and bottle - feeding require two different sets of skills from a baby. With breast - feeding, and with proper latching - on, a baby places her tongue beneath and around the elongated nipple to help create suction and extract milk. When drinking from a bottle, she uses her lips more and places her tongue in front of the nipple to control the fl ow of liquid. A pacifi er uses yet another set of muscles and refl exes. So it ’ s easy to see why a baby who has not yet caught on to breast -feeding could be confused when artifi cial nipples are introduced too early.
A breast - fed baby can successfully learn to switch back and forth from breast to bottle (this is a practical concern for nursing mothers who go back to work and continue to breast - feed when they are home); she can also use a pacifi er to satisfy her need to suck between feedings. There is no science to suggest that pacifi ers cause medical or psychological problems. The American Academy of Pediatrics (AAP) recommends no pacifi er usage for the fi rst month of life, so that correct breast -feeding technique is established; however, they have also released data that suggests the use of a pacifi er in the fi rst year of life, combined with crib - sleeping, cuts the risk of Sudden Infant Death Syndrome. (For more on SIDS, see pages 52–54 in chapter 2 .) If you want to discourage nipple confusion, avoid artifi cial nipples, including pacifi -ers, for the fi rst few weeks of life until breast - feeding and latching - on is well established.
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