Nipple confusion is a concern in the early days of establishing the breastfeeding relationship between mother and baby. While some babies do not seem to be effected by the switch from bottle to breast or breast to bottle, seldom a baby will come into the world - take one bottle - and then forever refuse the breast. Though NOT common, this is not a situation that a newly breastfeeding mother wants to encounter. A situation that may occur is where a newborn baby received bottles and a pacifier in the hospital and Mom goes home with the baby and soon realizes that baby seems hungry all the time, but doesn't "agree" to nurse. The sucking techniques differ entirely between breast and bottle. Using a bottle or pacifier can cause nipple confusion and interfere with the baby’s ability to take milk from the mother’s breast effectively. The establishment of sucking and latch-on patterns is especially critical in the early weeks. It is often recommended to wait until baby’s sucking and feeding patterns are well established (around 6 weeks) before introducing artificial nipples. During early days, removing milk from the breasts and establishing the milk supply for the baby is fundamental. If baby refuses for an extended period of time, milk should be expressed and fed to baby using an alternative to a bottle - to avoid nipple confusion. There are many suggestions mothers can try in cases where the baby refuses to nurse depending on the situation. Give baby skin-to-skin contact Use different nursing positions Try nursing in the bath Offer breast when baby is sleepy Express a few drops of milk so baby can taste and smell it at the breast Talk to the baby – soothe baby – make it a pleasant experience If baby still refuses – try to feed baby using an alternative method (spoon, dropper, cup etc) and try again later. | 
