It is my observation as a baby nurse that “nipple confusion” is not what it seems.
No Nipple Confusion
Bottle versus Breast
When you introduce a bottle to a baby who is learning to breastfeed, some babies do refuse to nurse at the breast again … temporarily. This is what lactation consultants call “nipple confusion.” But I believe your baby is not “confused” but is simply choosing the path of least resistance.
By comparison, at the very beginning of feeding it’s easier for your newborn to get milk from a bottle than from your breast. Milk from a bottle flows easily and immediately. Milk from your breast requires some sucking without reward until letdown (release of milk from the glands) allows the milk to flow easily. Your baby made a discovery, and wants the path of least resistance. There is no confusion about it.
Helping Your Baby
Knowing this may happen, there are some things you can do to help your baby transition from bottle back to breast.
You may express some milk with your hand or a pump to stimulate letdown and get the flow of milk started before you put your baby to breast. This readily available milk makes it easier for your baby to get instant gratification without too much work.
You may also leave some expressed milk on your nipple to give your baby the smell and taste that promotes a good latch (that is, a wide-open mouth as full of mom as possible) that will help your baby get the milk more easily.
You might also try putting your baby to breast before fully awake, letting natural sucking cues take over while your baby is still sleepy.
After successfully feeding with a bottle, and returning successfully to feed at the breast, your baby should be able to switch between the two methods of feeding as needed. It just may take a little patience and understanding.