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You need to go back to work and would like to bring on a combination of breast and bottle. But you have heard that this could lead to 'nipple confusion'. Do you need a lactation consultant? Perhaps you need a primer on nipple confusion.

What is nipple confusion all about?

Babies who are fed both by the breast and the bottle can sometimes have problems in recognizing the difference between the two nipples.

Sucking milk from the breast is quite different from sucking from a bottle in terms of technique. Add to that the ease with which milk flows from a bottle and you get a puzzled baby.

To suck or not to suck, that is the question

Most babies get confused if they haven't yet adapted to the breastfeeding technique. Yes, not all babies are born with an inbuilt manual on breastfeeding.

When you start feeding baby, brush your nipple against the corner of baby's mouth several times. This stimulates baby's rooting reflex and baby will turn towards nipple and start suckling.

It is very easy to give up in frustration and opt for the passive bottle-feeding method. But try to stick on and your efforts will be rewarded soon. Breastfeeding creates a bond between you and baby.

Signs your baby is confused

If your baby fusses and balks at the breast, refuses to latch on, and yet seems quite comfortable with the bottle, this could be a sign of nipple confusion. Some babies are so used to the breast that they reject the bottle. Sometimes you can't decide which is worse.

Slow and steady'

To avoid nipple confusion, wait until the baby is becomes a breastfeeding pro and then introduce her to the bottle at least a fortnight in advance of your return to work. Starting too early could lead to nipple confusion while waiting too long to start could result in her rejecting the bottle.

While a baby needs to be hungry enough to want to suck at an artificial nipple, you need to see that she is not so hungry that she turns irritable and fussy.

Start with a little milk in the bottle and gradually increase the amount. Or try breast milk in the bottle.

Involving someone else

Another thing that could work is letting someone other than you do the bottle-feeding. Let someone else in the family try bottle feeding baby and cuddle him while he is being fed, so that the baby gets a sense of warmth and security. Dads can help too! This could be dad's perfect opportunity to bond with baby.

Each baby is different in his or her own way; some may take to interchangeable feeding right from their birth, while others may drive you nuts trying to introduce the bottle. You really cannot predict which baby will have nipple confusion, but its best to wait until baby is at least 3 or 4 weeks old, before you feed him formula from a bottle.