Nipple confusion is not a myth

I was thinking about the conflicting advice moms get about pregnancy/birth/breastfeeding. A lot of it, I can understand why there might be two perspectives. But why do people claim that nipple confusion doesn't exist? I can only assume that these people are coming from a place of great breastfeeding luxury, because I've seen it with my own eyes. Back when I worked for AmeriCorps, if I had a dime for every woman who told me in perplexion or sadness or exhaustion, "no quiere", I could start hiring some LCs for community health centers.

Will introducing a few bottles here and there to a successfully breastfeeding baby destroy their ability to latch? Almost certainly not, and if that's the "nipple confusion" we're talking about then fine, it's a myth. Are there babies out there who can switch easily back and forth from birth? If we only consider those babies then fine, it's a myth.

But can many bottles early in the nursing relationship interfere with breastfeeding? The evidence I've seen with my own eyes says "yes", and I would add that I think it's particularly strong for moms who don't have a lot of access to breastfeeding education and support. Many of those women assume that a baby who is fussy at the breast just "doesn't want it", and if nipple confusion is a myth then I guess they're right. But if it's real, then they are the least likely to have anyone to talk to them about why it's happening, help them get the baby latched and happy, and suggest limiting bottles until the baby is a successful nurser.

Instead they had the best help we could give - a consult at the clinic, follow-up phone calls, and repeat clinic visits if they had a way to get there and we had time to see them. Sometimes things worked out, sometimes they didn't, but either way I was pretty sure nipple confusion was alive and well. So the only explanation I can think of for health care professionals saying it's not real is that they've only ever seen babies whose mothers had all the support they needed for a successful transition between breast and bottle.