There are many possible approaches. The starting point is to figure out what problem the baby is having at breast. Then one knows how to help solve it. Look at the baby carefully - anatomy, tone, behavior. Look at how mom is positioning baby at breast. First try optimizing positioning and see if the baby can make it work. If it's just that the baby is used to a preformed nipple, a nipple shield may be helpful, but it needs to be sized correctly to both mom's nipple and baby's mought; and applied to pull in as much of the mom's nipple/areola as possible. Skin to skin while the baby is calm (perhaps after giving 1/2 to 3/4 of the usual bottle feed) may cause the baby to search out the breast and latch on. Letting the baby wake up near the bare breast or on mom's shoulder may help too. And changing the way the bottle is used can help prepare the baby for taking the breast. Holding the nipple across both lips so the baby needs to open really wide, holding the bottle horizontally and the baby sitting or semi-sitting can help the baby control the flow, and using a wide based nipple (one that the baby can actually get his mouth to the base of, most babies can't do this on an Avent nipple) may help to model the open mouth position of breastfeeding. Catherine Watson Genna, IBCLC NYC *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]