When I was pregnant, I heard a lot about the challenges of breastfeeding and I mentally prepared myself for the rough road ahead.

To my surprise, my daughter took to the breast, and my milk was good, as the weight increased. My wife fed her breast milk in a bottle from the first week, and she moved between breast and bottle without any problems.

By the time she was 3 months old, he was having more trouble feeding her. She only eats from the bottle under certain conditions, such as being beaten or caught in a certain place. Then my daughter started refusing the bottle and started crying every time it was in front of her.

Instead of taking shifts, I now have the full burden of putting her to bed and bedtime because she only sleeps after eating. I can’t leave the house for any meaningful amount of time because she refuses to breastfeed outside. I was tired, felt trapped and regretted breastfeeding in the first place.

New mothers are cautioned against introducing the bottle early for fear of weaning the bottle to a leaking bottle too soon. But I hadn’t heard anything about bottle refusal before I saw it for myself – and it was taking a toll on my mental health.

My experience was not unusual.

Clare Maxwell, a midwife and researcher, struggles with her youngest son James’ bottle refusal.

At 12 weeks she offered one with no luck but kept trying, approaching her return to work deadline at seven months. Maxwell bought more than 10 different brands of bottles, hoping one would stick. She changed the temperature of the milk, others tried to feed him. Nothing worked.

“I immediately started looking for any paper on bottle refusal or any research, and there was nothing,” said Maxwell, a senior lecturer in Midwifery at Liverpool John Moores University In Britain.. “It was like it didn’t exist.”

However, parenting forums were flooded with thousands of posts asking for help with the same issue, so Maxwell set out to investigate.

In the year In 2020, Maxwell and colleagues published a study on the experiences of 841 mothers whose breastfed babies did not receive a bottle. They posted an online questionnaire to a few breastfeeding groups based in North West England and after two weeks there were so many responses they had to close. About 30 percent of mothers said not accepting a bottle made their overall breastfeeding experience worse.

Mothers gave different reasons for introducing a bottle, such as wanting to return to work or stop breastfeeding. Some women had to take a test or driving test or attend events such as weddings or funerals.

Others had serious health-related conflicts, including those requiring cancer treatment, surgical procedures, or medications that are safe to take while breastfeeding. Methods to overcome bottle refusal have had low success – except for forcing their child to go “cold turkey” which can lead to dehydration.

More than 80 percent of mothers in their visits with medical professionals said they had no advice or support.

“Many health care professionals shrug their shoulders in a way that suggests I should just get on with it,” said one respondent.

Another wrote that the only advice she received was that “it’s so important to do it alone. [breastfeed] And bottles were something bad mothers did. … [They] They were worried that the child would be caught nipple confusion And stop eating.

Expectant parents are advised that exposure to artificial nipples may impair breastfeeding and not to introduce bottles before the fourth week. According to the World Health OrganizationTen steps to successful breastfeeding” recommendations, health care providers should “counsel mothers about the uses and risks of bottle, breast, and formula feeding.

But is nipple confusion real? The evidence is shaky, at best.

A 2015 review paper In the Journal of Perinatology, they found 14 studies that both support and refute nipple confusion. But none of them provide proof of causation—in other words, there’s no research that definitively shows that artificial nipples cause some babies to reject the breast.

“At the end of the day, I don’t believe in the concept of nipple confusion,” said Emily Zimmerman, a speech-language pathologist and neuroscientist who co-authored the paper. “The message [around nipple confusion] It’s left moms and caregivers worried about adding bottles and bottles to their farm treatments.

Zimmerman heads Northeastern University. Speech and Neurodevelopmental LaboratoryIt studies the interaction between breastfeeding, feeding and the development of the first voice of infants.

As part of her research, she uses a pacifier attached to a pressure transducer system to measure an infant’s temperature. Lactation response pattern and how it changes in response to different stimuli. With the bottle, milk is released immediately when sucking. In order to stimulate the mother’s bitterness, the baby should first engage in uneven breastfeeding with the breast – it is used as breastfeeding – Down response. After the milk is pumped, the baby switches to a different, more nutritious drinking pattern.

“Research in my lab shows that full-term healthy babies can use any pacifier, bottle, nipple, breast, finger sucker and go back and forth without any problems,” Zimmerman said. “So the child can adapt and adjust.”

She also noted that sucking in newborns begins with a reflex controlled by the brainstem, a region of the brain that controls many involuntary actions, such as breathing and heart rate, even in adults.

By about 6 months, sucking has largely transitioned to a voluntary activity, due to greater involvement of the cerebral cortex. This area of ​​the brain plays a role in many higher-order functions, including attention, perception, perception, and thinking. So bottle refusal may occur because some babies have simply developed a strong preference for breast over artificial substitutes—and now have ways to express that preference.

But Maxwell pointed out that other babies do not accept the bottle in the first weeks of life, so there is no one correct answer. In her case, her son James eventually received a bottle from Maxwell’s identical twin. But for the majority of mothers in her study – approximately 60 percent – nothing worked.

My daughter, who is now over a year old, has never taken a bottle after three months. I almost hired a postpartum doula who specializes in bottle refusal, but she wanted $3,240 to fix it. And when I visited a lactation consultant, she tried to convince me that my daughter’s oral cavity was not functioning properly and suggested that she needed occupational therapy.

Instead, at about 6 months, I decided to give up the bottle and exclusively breastfeed, a self-employed mom who had the luxury of working from home. I slowly pushed her hard intake of food.

Would I choose to breastfeed again knowing what I know now? Probably yes. But with more awareness and education around bottle refusal during pregnancy, I may have been more mentally prepared and less alone in my situation.

“I think health professionals shy away from talking about it because they don’t know how it affects mothers’ decisions to breastfeed,” Maxwell said. But as mothers, we need to know so that we can make these kinds of informed choices on our own.

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