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uhm.... depends how badly you want to breastfeed and how determined you are lol. My baby started out in the nicu and had bottles only for the first 2 weeks of her life. I kept offering boob and by 3 weeks old she took it every time offered. I kept pumping and nursing for a while, I slowly quit pumping and she nursed exclusively after that. Moral of the story is, if breastfeeding is important to you and you are willing to "stick it out" I think it can be overcome with lots of patience and determination.
I've also knows quite a few other nicu moms whose babies were hospitalized much longer than mine and they were still able to breastfeed once baby came home.
I had trouble breastfeeding at the start, so I supplemented with formula as needed (probably only a few weeks), and then exclusively breastfed after that. Charlie never had any problem with confusion. But every baby is so different.
I think there is a guideline somewhere for how long to wait before introducing bottles if you are worried about nipple confusion. I can't remember what it is because we never gave my daughter a bottle. I was so worried about nursing and I was afraid to mess anything up so we just never gave her milk any other way. We also waited until she was 7 weeks old to give her a pacifier. In hindsight, that might have been a little over cautious but it did help me build a great supply because she was nursing all the time.
A lot of people will say wait 6 weeks before introducing the bottle or pacifier, to give yourself time to establish a good milk supply.
That being said, we had to give Grace a bottle sooner than that, because I ended up in the ER a few days after giving birth, so DH had to give her bottles. He also introduced a paci at that time. She never had a problem with any sort of nipple confusion. Then after that time, we tried to offer a bottle at least once a week, so that she'd be used to it when she started daycare. She never had trouble.
As someone else said, though, every baby can be different.
Just depends on baby. My son took bottles of pumped milk NO issue. He'd even take a bottle from me. My daughter? Never took a bottle. She had ONE in her whole life, she was teeny tiny and we got away for a quick dinner, she drank pumped milk was fine she never took another bottle again. My husband tried, my parents tried. We tried different bottles etc NOPE she flat out refused. She also never took a pacifier. Hated anything that was not my nipple.
It really does depend on the baby. My oldest wouldn't take a bottle of pacifier from anyone. She wasn't fussy about it -- she just refused it. She also went straight from breast to table food at just over a year, and we had to do it cold turkey, or I thought she was never going to start weaning. She wouldn't eat baby cereal, pureed foods, anything. My third never took a bottle, but that's because we knew I was staying home with her. However, that is NOT a mistake we will make again. We were never able to go anywhere without her.
My other 2 never had any nipple confusion and switched between the 2 with ease. We started my second on bottles 1-2 times a week at about 2-3 weeks old and did the same thing with my youngest at about 4-5 weeks. We needed to make sure they would eat at day care. We also used only the level 0, or whatever nipples on bottles, and we never went to a faster flow. That way, they still had to work at getting the milk out.
Mommy to Jasmine (17), Kirsten (13), Ana (12), Katie (2), Xavier (1), and...