Liz It is so distressing to have these babies who do not know what to do at the breast. We do not have CST therapists here in Cape Town (although some Physios are currently in training and we should have access to that type of therapy in the not too distant future) and I think that that will be our first line of therapy with these babies. The last baby I worked with who would not breastfeed, was a real challenge. He was a failed home birth and ended up being born via a Caesarean in hospital with suctioning and possible forceful attempts to latch at the first feed. I saw the mom on day 3 when the mother was attempting to breastfeed with a nipple shield, with little success. Following the goals as you set out, we finger fed the baby with ABM (Artificial Baby milk, or whatever we are currently calling it) until the mother was able to pump enough and then were able to phase it out and only use EBM. The mother's milk supply was maintained through the pumping. She co-bathed and co-slept with the baby and attempted to latch him at every feeding time. Staying sane was the hardest part but this mother was determined and on day 28 the baby went to the breast as if there had never been a problem. She returned the hired pump, threw away the tubes and syringes and cried with joy. 6 months later she was still exclusively breastfeeding. It was far more complicated than just putting breastmilk on the nipple, and using a tube (or SNS) at the breast was impossible because the baby would not latch. Support, time and patience, feeding the baby and maintaining the mother's milk supply are the ingredients which are needed and I do wish you good luck. It's a scary ride but the relief at the end is more than compensation. Rose Gauld RN RM IBCLC, Cape Town, South Africa *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html