Surface electromyography of facial muscles during natural and artificial feeding of infants: identification of differences between breast-, cup- and bottle-feeding.

According to current recommendations from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF),1 health workers should protect, promote and support exclusive breastfeeding for 6 months and continued breastfeeding up to 2 years of age or beyond. However, exclusive breastfeeding is not an option for all infants for several reasons. Newborn infants who need supplementation for medical reasons and infants with partial breastfeeding require feeding by an alternative method. Because of the negative impact of feeding nipples on the development of infant sucking behavior and the deleterious impact of bottle feeding in hospital on mothers’ subsequent choice of feeding method, the “Ten steps to successful breastfeeding” include step 9: “Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.”2 The main reason for the “ban” on bottle feeding is the assumption that it causes “nipple confusion”: the infant will have difficulties in sucking on the mother’s breast after having learnt to suck on an artificial nipple.