ReviewJournal of perinatology : official journal of the California Perinatal Association2015
Clarifying nipple confusion.
Review in Journal of perinatology : official journal of the California Perinatal Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- Preterm Infant Feeding: A Mechanistic Comparison between a Vacuum Triggered Novel Teat and Breastfeeding.Nutrients · 2018Trial
- A ducted, biomimetic nipple replicates breastfeeding mechanics through ontogeny in an infant animal model.Pediatric research · 2026Article
- A Ducted, Biomimetic Nipple Improves Aspects of Infant Feeding Physiology and Performance in an Animal Model.Dysphagia · 2025Article
- A Descriptive Investigation of Infant Feeding Bottles Marketed in the UK Designed to Replicate Breastfeeding and the Evidence That Underpins Them.Maternal & child nutrition · 2025Article
- Twin Challenges in Türkiye: Exclusive Breastfeeding Rates and Predictors of Breastfeeding Duration in a Tertiary Care Center.Children (Basel, Switzerland) · 2025Article
- Recommendations for endoscopy and sedation in the lactating patient.iGIE : innovation, investigation and insights · 2025Article
- Why have a bottle when you can have draught? Exploring bottle refusal by breastfed babies.Maternal & child nutrition · 2023Article
- Encouraging and Reinforcing Safe Breastfeeding Practices during the COVID-19 Pandemic.International journal of environmental research and public health · 2023Article
- Article
- Research Title: Factors Associated with Cessation of Exclusive Breastfeeding.Journal of multidisciplinary healthcare · 2021Article
- UK mothers' experiences of bottle refusal by their breastfed baby.Maternal & child nutrition · 2020Article
- Assessment of Bottle-Feeding Practices in Kassala, Eastern Sudan: A Community-Based Study.Open access Macedonian journal of medical sciences · 2019Article
- Pacifier use in newborns: related to socioeconomic status but not to early feeding performance.Acta paediatrica (Oslo, Norway : 1992) · 2018Observational
- Suboptimal infant and young child feeding practices among internally displaced persons during conflict in eastern Ukraine.Public health nutrition · 2018Article
- Re-thinking lactation-related nipple pain and damage.Women's health (London, England)Review
- Expectation of parental control and the maintenance of bottle-feeding in childhood.Jornal de pediatriaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Nipple confusion, an infant's difficulty with or preference for one feeding mechanism over another after exposure to artificial nipple(s), has been widely debated. This is in part due to conflicting statements, one by the American Academy of Pediatrics in 2005 suggesting that infants should be given a pacifier to protect against Sudden Infant Death Syndrome, and the other by the World Health Organization in 2009 stating that breastfeeding infants should never be given artificial nipples. Despite the limited and inconsistent evidence, nipple confusion is widely believed by practitioners. Therefore, there is a unique opportunity to examine the evidence surrounding nipple confusion by assessing the research that supports/refutes that bottle feeding/pacifier use impedes breastfeeding efficacy/success/duration. This review examined 14 articles supporting and refuting nipple confusion. These articles were reviewed using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale. Based on our review, we have found emerging evidence to suggest the presence of nipple confusion only as it relates to bottle usage and found very little evidence to support nipple confusion with regards to pacifier use. The primary difficulty in conclusively studying nipple confusion is establishing causality, namely determining whether bottles'/pacifiers' nipples are causing infants to refuse the breast or whether they are simply markers of other maternal/infant characteristics. Future research should focus on prospectively examining the causality of nipple confusion.
Indexed as
Identifiers
26181720What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.