Well, I don't care, to tell you the truth, what the clinical studies
say.  Babies can get used to a bottle nipple and then refuse the breast.
I would like to have those studies that he refers to, but that just does
not change the fact that babies who get used to drinking one way, often
continue to do that way.  It does not mean you can't change them, but if
we do not have to use a bottle nipple, why do it?  I can say that a baby
who only bottle feeds does not suck on my finger like a baby who
breastfeeds.  So this uniform method of sucking is not true, as far as I
can see.  Secondly, babies *do* drink when the drink from a cup.  They
do not suckle from a cup.  Babies do aspirate occasionally with a bottle
too and cup feeding was around a lot longer than bottle feeding.  I
think, if this Geoff is honest, that he would demand the same proof that
bottle feeding is safe.  On what basis does he say that bottle feeding
in prematures is safe?  Where is the proof?  I see lots of people
advocating bottle feeding in 32 week gestation babies and it makes *me*
sick.  If they are ready for the bottle, they are ready for the breast,
and should be there.  Indeed, they are ready for the breast

Of course, we do not hesitate to use nasogastric feeding for premature
babies, yet documented deaths have occurred secondary to ng feedings.
So perhaps we should feed them all IV until they are ready to
breastfeed.  But there have been deaths secondary to total parenteral
nutrition.  So what's the answer?  The answer is that we do what creates
the fewest problems.  And cup feeding creates the fewest problems when
used appropriately.  I personally have never heard of a baby aspirating
when cup fed, but obviously I haven't heard everything.

I agree that teaching cup feeding over the phone, though, is wrong.
Also, cup feeding would be a lot less necessary if we helped mothers
start breastfeeding properly instead of fiddling around until they are
"big enough" and making sure they can "take a bottle" before we start
breastfeeding.  It would also be a lot less necessary if we used a
lactation aid at the breast to supplement, if this is truly necessary.
Cup feeding and finger feeding (another option), should not be used if
the baby can take the breast.

I don't know if this answers all your questions, but that's my approach.
And sticking with bottle feeding just because "that is the way we always
did it" is not good enough.  As I pointed out before, the way "we always
did it was by cup", back to Egyptian times and Neolithic times.

Jack Newman, MD, FRCPC