A few words of warning about cup feeding.
 
When I worked as a lactation consultant in a "very resistant" unit, I frequently saw the negative side effects of cup feeding. When I first began working on this unit, many nursing infants were frequently supplemented with cup feedings. This was a unit that had originally engaged in a high degree of unnecessary supplementation and the cup was simply being used as a replacement for the formerly adored bottle. 

Consequently, I had abundant opportunities to observe behaviors that followed incidences of cup feeding.  Many of these infants did not approach the breast in a manner that facilitated latching or suckling.  For example, after many of these infants cued to nurse they did not demonstrate appropriate nursing initiation behaviors. Instead after they were placed proximal to the breast, they sat idly while their mouths were only slightly opened. They made only minimal movements with their tongues and they seemed to wait for their mother's breastmilk to pour into their mouths. Naturally, many of these infants became very frustrated, as did their mothers. The maternal breast became a withholding rather than a giving object for them because they had learned that there is another, apparently more efficient, way to gain comfort (i.e. nourishment, relief from thirst, relief from discomfort). 

I realize that part of the problem was the manner in which cup feeding was conducted. Many of these infants were being passively fed with a cup instead of allowing the infants to actively, gently and slowly use their tongues to draw the supplement to their mouths. However, I also noted ineffective nursing behaviors in infants who had been cup fed by sensitive nurses who  seemed to demonstrate an understanding of the principles of cup supplementing in their interactions with the babies.  

This seems to reinforce the concept that the experience of being nourished both physically and emotionally is a very complex issue for infants. Hence, any method of supplementation, even those methods that most closely mirror the oral physiology of nursing, should be weighed with the utmost seriousness. 

Keren Epstein-Gilboa MEd BScN RN LCCE FACCE IBCLC 
PhD (Candidate) 

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