Susan, Expressing breastmilk and feeding it with a spoon can work well for a baby who doesn't begin nursing witin 6-12 hours. If you can't express enough milk, the ABM can be given by cup or by fingerfeeding (using a nursing supplementer). There was a good article in JHL a couple of years ago--decision tree for when to supplement. Basically, if baby doesn't eat within 3-5 hours, evaluate for symptoms (not signs) of hypoglycemia, dehydration, and sepsis. If asymptomatic, reevaluate every hour until baby feeds or until baby becomes symptomatic. I tell parents to limit attempts at gentle awakening to no more than 5 minutes every hour. If baby doesn't awaken, put baby skin to skin or leave loosely wrapped or unwrapped and covered in crib. As you said, this is for healthy, term neonates. Bonnie Jones, RN, ICCE, IBCLC from the sunny (and pleasantly warm) S.W. USA