There are many reasons why a nursing mom might want her baby to take a bottle some of the time. Maybe you’re heading back to work, attending a special event, or simply craving a well-earned break while someone else takes over feeding duty for a bit.
Whatever the reason, it’s natural to wonder whether your baby will have trouble switching between breast and bottle — and whether “nipple confusion” is something to worry about. Here’s what to know.
What is nipple confusion?
Nipple confusion is a term used to describe what happens when a baby has trouble switching between bottle-feeding and breastfeeding. Most often it refers to a baby who is hesitant to breastfeed once they’ve been introduced to a bottle.
They may protest the different size or texture of a mom’s nipple. Or they may learn to appreciate the more effortless flow of milk from a bottle.
Is nipple confusion real?
Yes, it’s a real thing, though it may be more preference than confusion. Why? Babies catch on pretty quickly that they don’t have to work nearly as hard to get milk from bottles as from the breast.
To breastfeed, your baby needs to master the fine art of taking your nipple far back into her mouth and then using her tongue to pump out the milk (which can take a minute or so before it starts flowing). With a tilted bottle, a baby has gravity on her side: She can suck with her lips and get all the milk she wants right away.
So a baby struggling with nipple confusion may just be showing a preference for the quicker, easier route to a full belly.
Bottle preference is far from guaranteed though. In fact, most babies have no problem switching from breast to bottle and back again — and some do so with ease from the get-go.
“I’ve been giving my baby a bottle since day 2, as well as breastfeeding and she’s had no issues,” says What to Expect Community mom ginabean1101. “She figured out how to eat from both.”
But others, particularly those who take a little longer perfecting the art of suckling at the breast, do find it hard to transition from breast to bottle and then back to breast. That’s why most experts agree that you should wait until your newborn gets the hang of breastfeeding before you present a bottle.
When to introduce the bottle
For most breastfed babies, three weeks is the sweet spot for bringing out the bottle. By then, your milk supply is well established, and your newborn has likely mastered her nursing technique — but she’s still flexible enough to accept something new.
If you haven't hit your groove with breastfeeding by three weeks, ask your pediatrician if you should wait a little longer before introducing the bottle.
While three weeks is good guideline, every baby (and every breastfeeding journey) is different. Some circumstances call for earlier bottle-feeding. “By all means, please use a bottle to help with night feedings, work balance, or prolonged hospitalizations,” says Micah Resnick, M.D., F.A.A.P., pediatrician with TriHealth Population Health Organization in Cincinnati, Ohio, and member of the What to Expect Medical Review Board.
How to help your baby take a bottle
Once you have the timing right, use these strategies to encourage your little one to try the bottle. You can also use these tips for a baby who shuns the bottle in favor of breastfeeding at any point.
Choose the right nipple
You might find the most success with a slow-flow nipple (sometimes called a newborn nipple), which better mimics the pace of breastfeeding.
But if one bottle nipple doesn’t succeed, try another one. The milk should come out fast enough that your baby doesn’t get frustrated but not so fast that she can’t keep up with the flow.
Your baby may need a faster flow, says Dr. Resnick, if you notice she’s:
- Taking longer to finish eating
- Sucking fast with not many swallows
- Getting fussy while eating
And she may need a slower flow if you see her:
- Gulping
- Choking
- Swallowing hard
- Coughing
- Drooling more than usual
- Refusing to eat
What to Expect Community mom tss16 was using a bottle recommended for breastfed babies but says it was “waaayy too fast for my L.O. Once we switched him to the extra slow, he’s been fine and switches between bottle and breast fine.”
Let someone else do the honors
Babies often associate Mom with breastfeeding. Have your partner, friend, or relative offer the bottle while you’re out of sight.
But don’t worry that you’ll always need a stand-in at feeding time — once your wee one gets the hang of the bottle, she won’t care who gives it to her!
Mimic breastfeeding
Think about ways to make your baby’s bottle-feeding experience more like breastfeeding. For example:
- Slow the feeding pace: Hold the bottle at an angle rather than straight up and pause periodically to slow the flow.
- Interact with your baby, and provide skin-to-skin contact: “Skin-to-skin contact (also known as “kangaroo care”) is incredible!,” says Dr. Resnick. “It calms and relaxes both mother and baby, stimulates digestion and an interest in feeding, regulates temperature, stimulates the release of hormones to support breastfeeding and mothering, improves oxygen saturation, and reduces cortisol (stress) levels.”
- Switch sides: Halfway through feeding, as you might when breastfeeding, switch your baby to your other side, pausing to burp her when you do.
- Take a familiar position: “It can help to feed the baby with a bottle in a side-lying position,” notes Dr. Resnick. “Not only does this position mimic breastfeeding, it can also help babies more prone to reflux.”
On the other hand, while some newborns want bottle-feeding to be just like breastfeeding, others take to it better if the experience is completely different. If that’s the case with your little one, try a new location or even a different position.
Just keep in mind: Whether your baby loves the bottle or refuses it entirely, you’re not doing anything wrong — it’s all part of learning together.
Track your baby's feedings and get more expert tips and parent advice in the What to Expect app — so you can spend less time guessing and more time snuggling.
Will using a pacifier lead to a bottle preference?
Despite what you might hear from well-meaning family or friends, offering your baby a pacifier won’t make her like bottle-feeding more or lose interest in breastfeeding.
Not only can pacifiers soothe your baby and give you a much-needed break, but offering them at nap and bedtime is a recommended strategy for reducing the risk of sudden infant death syndrome (SIDS), according to the American Academy of Pediatrics (AAP).
The key is introducing the pacifier after you’ve both gotten the hang of breastfeeding. As with bottles, the AAP recommends waiting to pop the pacifier until your baby is 3 or 4 weeks old.
If your baby is very fussy and hard to soothe, though, ask your doctor if a pacifier might be okay earlier than that. Dr. Resnick says he never suggests delaying pacifier introduction for an extremely fussy baby. “It can really help calm the baby and the parents,” he says.
What to do if your baby prefers bottle-feeding
If your little one smitten with the bottle, don’t worry — you can gently guide her back to the breast. Try these tips:
- Revisit the basics: Remind your baby how soothing breastfeeding can be by cuddling her skin-to-skin while nursing. Check to make sure she has a good latch. (If she makes clicking noises, becomes overly frustrated or fussy, or chews or roots while trying to breastfeed, she may be struggling with her latch.) Reach out to your doctor or a lactation consultant for extra guidance.
- Make breastfeeding easier: Express a little milk before feeding so the flow starts right away for your baby.
- Make bottle feeding a little harder: Make your little one work just a bit for the milk by experimenting with nipples to slow the flow. “We recently started giving our 3-week-old pumped breast milk from a bottle and the size 0 nipples were making it way too easy for him so he wouldn’t want to breastfeed,” says What to Expect Community mom katieloo2. “Used the preemie, which slowed his eating way down.”
- Time it right: Offer the breast when your baby is hungry but not frantic. If she’s starving, she may not have the patience to latch on or suck enough to get the milk flowing.
- Take a bottle break: If the whole switcheroo has given your baby a bad case of nipple confusion, just stick with breastfeeding until she’s gotten it down solid again.
Nipple confusion doesn’t have to derail your feeding journey. With patience, timing, and a little trial and error, most babies learn to move easily between breast and bottle.
Yes 
No 
