In her book Bumpology, Linda Geddes sets to work explaining the science behind pregnancy, birth and the all important baby-raising bit. She has dug around behind the scenes to uncover the real scientific evidence that exists. Then she has pulled together accessible ‘answers’ to questions that we all have about the minefield of reproducing.
She tries to explain clearly what scientists really know about, say, caffeine intake during pregnancy or the impact of pain relief on the length of labour. There’s so much that I like about her book, it’s a whole other post for another day. But one thing I like most about it is her attempt to answer this single question:
Does Nipple confusion really exist?
The received wisdom in the UK at least is that bottle feeding too early on (even if there’s breast milk in the bottle) is not a good idea because babies get confused. That once this magical line has been crossed the baby simply won’t go back to or start feeding from the breast. This was the message I got from all of the breastfeeding sessions I attended. Loud. And. Clear.
Well, in trying to weigh up the evidence and give a clear answer to this question Linda found a study undertaken at Dartmouth Medical School in New Hampshire, USA. It involved 802 mother-baby pairs who had a combination of breast- and bottle-feeding during their first week in hospital. Of the study she says this:
"Although such combination feeding shortened the amount of time that white babies were breastfed, this was not the case in Latino or black babies. While it’s possible that black and Hispanic babies are biologically different to white babies, this seems improbable.
More likely is that the use of a silicone teat was irrelevant, and the white women were giving up breastfeeding for different reasons, possibly because they expected breastfeeding to be a struggle after bottle-feeding and this then became a self-fulfilling prophecy.
By contrast, Hispanic women have a strong tradition of combining breast- and bottle-feeding and see it as completely normal.”
So, while the mixed feeding seemed to scupper breastfeeding for the white mothers this was not the case for the black and latino mums. Huh. Linda’s tentative attempt to find an explanation for this difference is logical, right? In a (white, middle class) culture where antenatal education unfailingly sends the message that mixed feeding is firstly not a thing, and secondly a bad idea, are we creating mums and dads who are set up to fail?
While I cannot speak for others, Linda describes my experience described to a tee. While we both had physical difficulties with breastfeeding if I really scrutinise what happened, one of the biggest hurdles was that my heart had sunk. My boy had bottles very early on for various complicated reasons and as a result I felt like a fraud. And why wouldn’t I? Everything we had read and been told in antenatal education clearly stated that bottles and then breast was simply not an option. In fact bottle feeding didn’t exist, and nobody ever said the phrase ‘mixed feeding’ apart from the lovely midwife we saw on Day four. The result? We felt scuppered and behaved accordingly.
Whole lines of products have been created to pray on our fears of nipple confusion. I know, I bought them all thinking I could ‘fool’ my baby back (when what I really needed was good, pragmatic help with breastfeeding). We tie ourselves in knots trying to work out the right time to switch. New mums often feel wretched if a bottle’s introduced before the allotted deadline that her midwife or health visitor probably rather randomly suggests. The suggestion that the confusion we so dread may not exist… or at least not as concretely as we vehemently insist… is worth a moment of our time.
Our insistence on the existence of nipple confusion is fuelled by a desire to just get more women to breastfeed. It’s about steering mums away from bottles, full stop. Now if this worked as a strategy then so be it. But it doesn’t work. It’s time to try something new.
Photo courtesy of Sarah Pilliard on Flickr.