This area brings up many philosophical questions that we have raised at the hospital where I work. Part of the question, for me, is this: what do we (as health care professionals and breastfeeding supporters, "fanatics", even) want to REALLY have happen in the first 24 hours or so and then, what is physiologically realistic for the newborn and mother?? I think/feelbelieve, answering the first part of the question, that I want the mom and baby to feel good about being together, to have some uninterrupted time together, to get the warmth and closeness that comes from having a baby happily at the breast. If the baby actually breastfeeds, so much the better! If, however, the baby does not, or cannot, or is not ready, or mom is stressed, etc., etc., then what, exactly are we worried about?? Unless there is an identified problem (not always obvious within the first 24 hours) , then we can confidently expect that the baby WILL latch on sometime within the first 48 hrs or so. Now, we all know of situations in which we wonder whether outside circumstances will make this difficult or impossible, but that is a matter for referral to appropriate follow-up resources, as available. OUR job is to support the normal, appreciate that sometimes the best we can do is keep everyone positive and NOT create the feeling in mom or both parents that there is a problem, that something is wrong with the baby who doesn't latch on within 24 hours. Unless baby has a low blood sugar problem (with risk factors for checking this), below 35, we don't do anything except promote togetherness and continued gentle attempts at latching. We are fortunate in having pretty good follow-up agencies in our community (including one home visit program that the hospital provides, by contract), but it has taken about six years to get to this point. I personally don't think it a "baby friendly" practice to use tube/syringe or cup feeding for a normal, healthy newborn who hasn't met some arbitrary guideline for latching on well (especially in view of the other intervening factors, such as epidural anesthesia, that could be contributing to this). I'd wonder where the "five hour" or "24 hour" rule came from anyway?? Since most newborns have a deep sleep phase for the first 24 hours or so, maybe we're getting worked up over nothing... Jeanne Brotherton, RNC, IBCLC To paraphrase Chesterton, "It's not that they can't find a solution, it's that they can't see the problem..."