Written by Sarah Mansell Published on 12th August 2021 Updated on 16th August 2022

Of all the slightly odd breastfeeding terms, nipple confusion is maybe one of the most curious. Probably because it makes us think of a confused nipple. Which is quite funny really. But nipple confusion isn’t actually about your nipples being confused and it isn’t actually very funny— it’s a broad term that can refer to a baby who refuses to feed from a bottle, or one who tries to breastfeed in the same way they feed from a bottle. Which can be distressing for mamas and little ones.

The technical bit 

Breastfeeding and bottle-feeding have different mechanics, which is what can cause nipple confusion in the first place. According to the Proceedings of the National Academy of Sciences, the mechanics of breastfeeding involves the following: 

  • To properly latch on to your breast, the baby opens its mouth very wide so that the nipple and a big part of your areolar tissue can reach deep inside.

  • Your baby then uses their tongue and lower jaw to do two things at once: hold the breast tissue in place against the roof of their mouth, and create a trough between the nipple and the areola. (Honestly, breastfeeding is MAD). 

  • The baby’s gums compress the areola and their tongue moves rhythmically from front to back to draw out milk. 

When your little one is drinking from a bottle, they don’t use the same technique, because the milk will flow no matter what a baby does. (Thanks for that gravity.) When a baby feeds from a bottle it goes something like this:

  • They don’t have to open their mouth wide or create a tight seal with properly turned-out lips.

  • It isn’t necessary to draw a bottle nipple deeply into their mouth, and there’s no need for the back-to-front milking action of the tongue.

  • They can suck only with their lips or “gum” on the rubber nipple.

  • If the milk flows too quickly, a baby can stop it by thrusting its tongue up and forward.

Ok, so what’s actually confusing them

Nipple confusion is usually caused by the interference with their breastfeeding instincts during the early days of feeding. Your little one has an instinct to breastfeed and they will naturally use that technique described above. But if they’re being fed from a bottle, it can interfere with the process and mean they then struggle to latch properly. 

What does it mean for mom and baby? 

If your baby is struggling to latch, then you might experience engorgement in your breasts. Which all moms will know, is a mother-pumping pain in the ass. So you will want to try and cure this nipple confusion ASAP. You can try gently hand expressing a little milk to soften the areola or set your breast pump to minimal suction power. 

As we know, the more you feed, the more you produce, so it makes sense that if your little one is struggling to feed then you’ll stop producing so much milk. Which is far from ideal. The best solution here is to maintain your usual expressing patterns to keep your body producing. This is where having a portable breast pump like Elvie Pump can be helpful. It means you can express as you normally would (even on the go) and then you’ll be ready when your baby is ready.

How to calm and soothe your baby

Soothing a hungry baby with nipple confusion is no easy task and can be distressing for both of you. And while we don’t have a magic solution to it, these little tips will hopefully help. 

  • Practice those lullabies – singing and talking calmly to them can work miracles. 

  • Hold your little one against your shoulder or in a sling if they don’t like to be held in a nursing position.

  • Keep the environment peaceful with low lighting and minimal noise. Basically everything you’d like for a calming mood. 

  • Take a walk outside or a relaxing warm bath together because keeping yourself calm will transfer to your baby. 

  • Deal with the challenge one feed at a time and don’t think about what’s going to happen during the next feed. Listen to those yogis and ‘be in the moment.'

  • Reduce outside commitments for the time being and do minimal household chores (any excuse) to give yourself time to concentrate on your baby.

  • Make yourself comfortable as you try to breastfeed. We love a big pillow and a comfy chair and of course, Netflix. 

  • Express milk to feed to your baby and to maintain milk production. The hormone oxytocin, which you produce when you do this, can be calming for you both. 

  • Use relaxation techniques such as massages, relaxing music, warm baths, subdued lighting, and the breathing exercises taught for labor.

  • Enlist your partner’s support. They have an important role to play in taking care of you both.

Still feeling confused about nipple confusion?

We know that telling a new mom to relax (especially one who’s struggling to breastfeed) can be quite counter-intuitive, but the more relaxed you are, the more relaxed your baby will feel, and the more likely it is that they’ll latch. Nipple confusion can be a real issue for lots of mamas, so know that you’re not alone, and always seek professional advice if the issue persists. 

The medical information in this article is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your doctor for guidance about a specific medical condition.