Article

Hospitalization for Nipple Confusion A Method to Restore Healthy Breastfeeding

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Abstract

Background: The World Health Organization has encouraged all facilities providing maternity services and care for newborn infants to adopt the “10 steps” of successful breastfeeding. This includes not giving artificial teats to breastfeeding infants because they may cause nipple confusion. We present a multimodal hospitalization protocol for infants with nipple confusion, a multimodal relactation method that supports breastfeeding couplets. Purpose: To investigate the effectiveness of hospitalization as an intervention for nipple confusion. Method: Data related to nipple confusion in patients hospitalized between January and December 2012 at Kemang Medical Care, Jakarta, Indonesia, was reviewed. Survival analysis was performed to evaluate the relationship between infant age and intervention outcomes. Results: There were 58 cases of nipple confusion during the study period. Most subjects (96.6%) totally rejected breast contact. Forty-six cases (79.3%) used bottles because of tongue-tie. The length of hospitalization varied from 1 (56.9%) to 5 days (3.4%). Fifty-three cases (91.4%) were able to successfully breastfeed using our protocol. Younger babies had greater breastfeeding success. Conclusion: Hospitalization for nipple confusion with multimodal management is effective for treating nipple confusion. Tongue-tie can lead to difficulties in initiating breastfeeding, and early introduction to artificial teats can lead to nipple confusion. Early detection and treatment is desirable.

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... The literature is rich with observations and studies of the differences between breast-and bottle-feeding. These studies highlight the disadvantages of bottle-feeding, especially the problem of nipple confusion: changes in feeding behavior that make breastfeeding more difficult after exposure to bottles (Batista et al., 2019;Mizuno & Ueda, 2006;Moral et al., 2010;Praborini et al., 2016). However, the observations are based on subjective descriptions of the tongue and orofacial muscles, specifically using visual analysis of videofluoroscopy swallow (Hernandez & Bianchini, 2019), EMG measurement of facial muscles (França et al., 2014), recording of swallowing sounds (Tamura et al., 1996), and rates of sucking and breathing (Taki et al., 2010). ...
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