Nipple confusion, my nemesis. I wish I knew the secrets to preventing it, and it may depend on the temperament of the baby because I have one friend who had no problem switching between bottle and boob with her first baby, but experienced nipple confusion with her second. To those who are interested, here is my advice when it come to trying to avoid it.

-Stay in the hospital as long as possible. Nathan and I left too early. The nurses wanted me to stay an extra day to get more help with breastfeeding, but we were too anxious to leave and I thought I could just figure it out on my own. Yeah right! Had I stayed that extra day I could have gotten the extra help I needed and perhaps gotten to the point where I didn't need the nipple shield. I left instead and continued to use the nipple shield for far too long. Heaven forbid you need to use a nipple shield, but if you do, do not prolong the use. Get rid of it ASAP!
-I also never learned very good holding techniques either. I recommend getting used to nursing without the aid of a pillow like the boppy pillow (if you're going to use one) because you wont have it everywhere you go. I opted to bottle feed Hudson when out-and-about because I was not comfortable with holding him and nursing him without it. I also was too self-conscious to nurse in public for fear that someone would see a nip-slip, so I gave bottles to try to avoid this. After going through nipple confusion, if I could go back I would whip my boobie out no matter who saw it if meant avoiding all this.
-Another thing I would recommend is avoid introducing any artificial nipples for as long as possible. Not only was Hudson introduced to the nipple shield early, I gave him a pacifier the first night home from the hospital. He was fussy and not sleeping so I tired giving it to him. It didn't really work, but I continued trying to use it from there on out. Hold off as long as possible.
-Last and certainly not least, avoid introducing the bottle too soon. You have to make sure breastfeeding is well established before doing this. I believe it is recommended to wait 3-4 weeks before doing so. I did not do this, actually Hudson was given a bottle within the first week while I was napping once. I wasn't very happy about it, but I never thought nipple confusion would happen to Hudson and me. I would also say that when you do start with bottles have someone else feed it to him, so he knows when he's with mommy all he gets is boobie.
-Get help ASAP. If you feel like something is going wrong with nursing seek help immediately to correct the problem. Don't assume it will get better on your own. I waited over two months before I contacted a professional about my issue and by then it was nearly too late to do anything. I am still having issues with it. Perhaps talking to someone right away will nip the problem in the bud. I also recommenced that you perhaps find a lactation consultant that you feel comfortable with and stay in communication with her. From my experience, lactation consultants working outside the hospital are more personable and willing to work with your problems individually.

I'm no doctor or anything, just a mom whose lived this first hand, and I'm not claiming that by doing these things it will not happen to you. I also understand that in some cases medical interventions are necessary for the benefit of your baby. Do not fight these. The doctors and nurses know what they are doing (in most cases, lol). These are just things I've learned from my personal experience. It is a very rewarding to nurse your baby, so I wish nothing but success upon all those who are and will be doing it, and if it doesn't work out for you like you hoped please don't beat yourself up over it. You are not a less fit mother if you cannot breastfeed. You need to do what's best for your baby and yourself.