Dear Friends:
 
Cynthia Howard (PEDIATRICS Vol. 111 No. 3 March 2003, pp. 511-518) discovered 
much the same thing, save for two exceptions.
 
Doesn't the WHO recommend the cup because it is easy to clean and some form 
of a cup is accessible to everyone?
 
My personal belief about alternative feeding methods is that it teaches 
families that breastfeeding is important by not using bottles. What do you all 
think?
   
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Randomized Clinical Trial of Pacifier Use and Bottle-Feeding or Cupfeeding 
and Their Effect on Breastfeeding 
Methods. A total of 700 breastfed newborns (36–42 weeks, birth weight 2200 g) 
were randomly assigned to 1 of 4 intervention groups: bottle/early pacifier 
(n = 169), bottle/late pacifier (n = 167), cup/early pacifier (n = 185), or 
cup/late pacifier (n = 179). The cup/bottle intervention was invoked for infants 
who received supplemental feedings: cup (n = 251), bottle (n = 230). Data were 
collected at delivery and at 2, 5, 10, 16, 24, 38, and 52 weeks’ postpartum. 
Intervention effects on breastfeeding duration were evaluated with logistic 
regression and survival analyses.
 
Conclusions. There was no advantage to cupfeeding for providing supplements 
to the general population of healthy breastfed infants, but it may have 
benefitted mother–infant dyads who required multiple supplements or were delivered by 
cesarean. Pacifier use in the neonatal period was detrimental to exclusive 
and overall breastfeeding. These findings support recommendations to avoid 
exposing breastfed infants to artificial nipples in the neonatal period. 
------------------------------------------------------------------------------
---
warmly,

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
_http://www.breastfeedingalwaysbest.com/_ 
(http://www.breastfeedingalwaysbest.com/) 
www.myspace.com/adonicalee



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