The following story is from a woman who was going back and forth from bottles to breastfeeding and this is what they learned.
The nipple shape didn’t seem to matter at all, the term nipple confusion is actually confusing in itself.
The thing that confuses the baby is the sucking.
Generally, when people bottle feed they lay the baby across their lap like they are going to breastfeed and then put the bottle in the mouth. When the baby compresses the nipple of the bottle, air goes in and milk comes out – the baby does not have to suck at all!
This is gravity feeding, and the baby has to either swallow or choke regardless of flow or how hungry he is. So you are making a fois gras baby! The baby looks hungry because he is gulping down the milk, it’s a reflex to keep from choking (think keg stand). When a baby gets used to this, he stops sucking and lets the milk flow into his mouth with minimal effort.
When the breast is introduced and milk doesn’t just fall out of it, baby gets confused and frustrated. So the solution is to make the baby suck the milk from the bottle. We did this 2 ways.
First, we use special bottles with nipples that have a weird little tube in them that makes it so that the air only flows into the bottle when the baby sucks (think baby bottles).
Second, we did not lay him down to bottle feed, instead he sat up and we held the bottle horizontal so that he was not ‘gravity feeding.’
Also, we did what is called ‘paced feeding.’ We let him suck the bottle for about 20 swallows, then tip the bottle down so that no milk is coming out. Wait and watch- the baby will pause, then do a small rapid ‘flutter suck.’ This is a reflex that stimulates your nipple to eject more milk. When you see this, tip the bottle back up for a milk reward. You don’t want the baby to lose this reflex because it is part of the communication between your body and his and it is crucial to successful breastfeeding.
One last thing, pump during or after (within 1 hour) every bottle feeding to maintain your milk supply and alert your breasts that baby is hungry. The key to increasing milk supply through pumping is frequency. So, never more than 10-15 minutes, but at every feeding in which a bottle is used.
Except at night, sleep as much as possible between feedings at night! If you are trying to transition back to full time breast, you know you are ready when you can pump as much as baby eats after each feeding -this is for babies who have to be supplemented with formula for whatever reason.
So, part of it is having the right nipple, but also a big part is encouraging baby to retain his reflexes that make him a natural breast-feeder and keeping your body in the loop.
After baby was on formula for 1 week, he was rejecting the breast and my milk supply was low. I was so devastated. We had a lactation person come help us and within a week and a half we were breast only!