This is my first post to LACTNET. I am a long-time LLL Leader (since 1967), still active with an LLL group in the Seattle area and a member of the LLLI Board of Directors. Art and I have three grown breastfed children. I have been reading LACTNET for almost two months now with a great deal of appreciation for all of you who are contributors to LACTNET. I gain hope for the world's women and children as I read your postings about all your good work. I want to reply to Ruth who is looking for ideas about a baby who will not latch on. The mechanism that generally triggers latch on in the baby is the stimulation of the nerve endings in the roof of the baby's mouth which would explain why the baby will finger feed. When mothers have large and/or flat nipples there are times when enough nipple does not hit the roof of the mouth to trigger the reflex. If the baby has gotten a superstimulous such as a bottle nipple, pacifier, (or finger) sometimes they don't recognize the feel of a nice soft breast nipple. Ideas that have worked for mothers I have worked with include (not in any particular order of effectivness) 1)getting the baby sucking well on the finger and then quickly removing the finger and when the baby is reaching to rapidly insert the nipple in the mouth as far as possible.2) making sure the baby is opening the mouth wide enough by tickling the lips 3)sometimes a mother has to insert a clean finger under baby's tongue, pressing the tongue up to the roof of the mouth to trigger the reflex. 4) some mothers have found that putting ice on the nipple or manually stiulating it to firm up the nipple helps.5) Shape the nipple by putting the thumb above and index finger below, well behind the arola, gently squeeze the nipple into a more oval than round shape and slightly tilt the nipple upward so that it is more likely to hit the roof of the mouth 6) Using the "rapid arm movement (RAM)" pull the baby close to the mother's body and breast almost to the point of burying the baby's nose in the breast. This has worked wonders for a few non- latchers. I don't know if it is because they can't breath with so much breast in the nose that they open their mouth wider to catch a breath or what but at time it is amazing to watch a baby latch on when nothing else seemed to work. 7)the "football hold" seems to work for a few who can't seem to latch on when in other politions.8) tucking a soft and blunt-ended dropper full of breast milk into the corner of the waiting mouth of the baby and giving occasional squirts to stimulate a swallow will sometimes get the baby sucking. 9) carrying the baby for much of the time skin-to-skin. Something about the extra skin contact seems to help the baby get better organized to suck. Good luck. I hope at least one idea helps. Good luck!