I've been down that road before. It's frustrating, isn't it? Nipple confusion isn't something that happens to every baby, but when it happens it's a very real problem. I have good news for you, though. The urge to suckle is very strong in those first six months or so. If you go cold turkey on the bottles, and stick to it, and really commit, most babies will be back on the breast within four or five days.
1. Get the bottles out of the house completely, so you won't be tempted to cave in at a really difficult moment.
2. Pump to maintain your supply, until baby is nursing well again. A drop in supply is the biggest danger, once baby is out of the very vulnerable newborn period.
3. Keep baby close. Go topless as much as you can. Sleep with baby. Give baby lots and lots of opportunities to nurse, in varied positions and situations. If baby refuses, don't push. Act like you don't care one way or the other, which is hard to do, but it helps to keep it from becoming a power struggle. Try offering every ten minutes or so when baby is awake. If one or both of you is upset, stop trying, and try again ten or fifteen minutes later. Try outdoors, in a warm bath, lying down, walking around, in different rooms, in a carrier, etc.
4. Try nursing while baby is drowsy or sleeping-- lay baby down on her side and slide in next to her and offer the breast lying down. Sometimes a sleepy baby will latch more readily.
5. Try pumping just until the letdown, and then offer baby the breast at that moment, when the milk will flow fast and easily. You might also try dribbling a bit of milk on your nipple before offering the breast, or expressing a few drops.
6. If baby goes three hours without accepting the breast, offer a few ounces of milk-- but not in a bottle. You'll want to offer it in a way that does not allow sucking. Try a medicine dropper, or a syringe, or a little cup like the ones that come with liquid cold medicines. Put the milk way back in baby's mouth, not enough to be uncomfortable for baby, but far enough back that it doesn't just dribble out. It can help if you have somebody else who can help with this. It's slow. Watch baby's pees-- you don't want to offer so much milk that baby isn't interested in nursing, but you want to offer enough to maintain hydration. If this goes on for more than about five days, I'd look into getting hold of a baby scale, or finding a supportive health care provider or LC who can keep an eye on baby's weight.
7. Don't use a pacifier. The breast can be the only sucking available. If you're desperate, and baby really needs to calm down in order to be able to focus on latching, offer a clean finger to suck for just a minute or two.
I went through this with two of my kids. The first time, I wasn't consistent. I caved in and offered the bottle when she got too upset. We never did get her back onto the breast, and I wound up with a lousy cycle of months of pumping and formula. The second time, with DS, I never intended to give bottles but he was given them in the NICU without my consent, and bam-- we had breast refusal again, in a baby who had been latching well. I committed-- I said no more bottles, that's it, no more, and it worked. He went on to nurse into toddlerhood.
Good luck. It can be tough, but it can be done. It just takes nerves of steel!
