Nipple confusion, alternative feeding methods, and breast-feeding supplementation: State of the science

Mothers of preterm and term infants frequently experience breast-feeding problems that make it necessary for them to use supplemental or complementary feedings. Although bottle feeding is used most frequently, alternatives to bottle feeding are frequently recommended to avoid nipple confusion. This report reviews the evidence of a relationship between exposure to artificial nipples and the development of nipple confusion. It also examines the effects of alternative feeding methods such as cup feeding, finger feeding, spoon feeding and gavage feeding on physiological responses of infants and long-term breast-feeding outcomes. This report recommends further research before alternatives to bottle feeding are routinely implemented. Copyright © 2001 by W.B. Saunders Company