Updated: Feb 25, 2021
I recently sat with a new mom and her newborn baby as she told me about her breastfeeding struggles in the first week of her baby's life. She said the information I gave her about breastfeeding before she gave birth was conflicting with what her mother-in-law was telling her.
She said that when she was exhausted, her nipples were in so much pain and the baby just wouldn't stop nursing, her mother-in-law suggested giving her baby a bottle of artificial milk to give her and her nipples a break. "I was able to get some sleep and (the baby) doesn't have any nipple confusion", She said, shrugging.
It would certainly seem that this situation turned out just fine. And it did! The tired mamma got some well-deserved rest and the baby got fed. These two things are so important! Depending on this mom's goals for breastfeeding, it is not necessarily a problem.
See where I'm going here? The perception of receiving conflicting information depends on what you want for your breastfeeding relationship with your baby. This can vary from parent to parent. If you would like to exclusively breast/chest feed, evidence recommends that the use of artificial nipples on bottles and pacifiers are not used until the baby is 4 weeks old. This gives mom and babe time to learn effective positioning and latching techniques, establish a solid supply of mature milk (by way of the baby nursing frequently), and create a household routine.
In regards to nipple confusion, lactation professionals aim to provide information on what could happen if an artificial nipple is given during this 4 week waiting period. Your baby may not have nipple confusion, but more so, artificial nipple preference. And this is because it is easier for a baby to get milk from a bottle than from a breast. Don't we all prefer the easy route?? So essentially, your baby my start preferring the bottle and refusing the breast.
Another risk of using a bottle or pacifier in the early days and weeks is that it can inhibit your body's ability to establish a sufficient milk supply for your baby. If your baby isn't feeding, your breasts aren't receiving the message to make milk. In other words, breasts don't make an indefinite amount of milk after birth. They need your baby to tell them how much to make. And that can fluctuate depending on your baby's growth spurts (see: cluster feeding). Furthermore, if your newborn is using a pacifier at night and is not waking to feed at least every three hours, it can be a risk to your baby's health and well-being.
If you plan on giving your baby a bottle instead of nursing at their regular feeding time, it is recommended to pump for 10 minutes on each side in order for your breasts to get the signal to still make milk.
For more details on milk supply, see my blog "Will I Have Enough Milk".
As for nipple pain, it can be uncomfortable in the beginning, but should never be painful. This should be addressed immediately in order to get off to a good start with breast/chest feeding. And trust me, I KNOW how hard it is to figure it all out and how difficult it can be to know what is best in the moment. Especially when your baby is hungry and you are in pain and exhausted. I encourage you to gain the tools and knowledge before your baby is born to understand what normal newborn behaviour and feeding looks like - including cluster feeding in the first week! This is a big struggle - emotionally and physically - for many!
So don't hesitate to reach out to a lactation professional for advice and support as soon as things become difficult.