I only see babies after they are long gone from the NICU. My perception is that having a baby at the breast with a nipple shield with appropriate follow-up is way better than having them exclusively bottle-fed...which is what I see most frequently. In my experience, if a baby leaves the NICU removing some milk on his own at the breast, it seems they have a much better chance at long-term breastfeeding. If they are exclusively bottle-fed until they come see me at 2-3 months of age, it is sometimes impossible to convince them to take the breast. (I should say I can usually coax them into staying on if I squirt milk quickly behind the shield the entire time, but many parents will not do this at home.) The keys to success as I see it would be: -being sure the baby is on the breast itself, not just the tip of the nipple shield -pumping as long as needed to optimize supply if it helps baby mostly get food at the breast -making sure the baby always opens WIDE before getting on the shield (this really helps when time to wean off shield, AND helps wqith getting baby on farther) -follow-up frequently with naked weight checks and pre/post weights until SURE the baby is flying solo. Kathy Leeper, MD, IBCLC Lincoln, NE *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html