This is only my second posting, but I too would like to welcome David Page. A professional person like yourself is always valuable in our field. Thankyou for the interesting infomation to date. I have a couple of questions for you:I reiterate what you wrote "Sucking a bottle/pacifier/finger constricts and deforms the jaws which surround the airway with upward and backward forces acting against proper down and forward growth. Tongue and swallow patterns become abnormal, and oxygen saturation drops as mouth breathing increases" What is your opinion of fingerfeeding? As I look after babies with Down Syndrome, and babies with cleft defects, I do use fingerfeeding, the length of time this is used can vary from a few days to a few weeks to months. This latter being used for a baby with a total cleft palate of the soft and hard palates, as a way of getting the baby off the naso-gastric tube. She never learn't to breastfeed or bottlefeed. She fingerfed for 9mths, then drank from a cup, which we had introduced earlier but without success. Have I done something wrong here? It is my experience that Down Syndrome babies learn to feed at the breast quicker if fingerfeeding is used rather than naso-gastric feedings. Also fingerfeeding is used often here in Switzerland for term babies, who require extra fluids, due to medical reasons,thus avoiding nipple confusion. My next question: What do you think of the use of pacifiers in premature babies, especially extremely small ones under a kilo in weight? As far as I am informed the hard palate is easily misshaped in these babies, and other premies of course too! Is it to assume that the smaller the baby the worse the damage? What can one do when the staff don't have time to soothe the baby and give him/her a pacifier instead? I saw a 25 weeker (now 40 weeks) the other day with massive nasal breathing problems, nasal prongs in the nose for oxygen, a very highly arched palate, and a pacifier in her mouth, the latter is surely a hindrance! BUT what can we do, it is sometimes a very viscous circle! David I would very much appreciate your thoughts, and knowledge in this area. Kindest regards. Kerri Frischknecht,RN,RM,IBCLC. *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html