Barb cole et al. i love the quote (from someone) "better to use the mom as a pacifier.......than to use the pacifier as a mom !!!" on a more realistic note i know that babies need to suck (as evidenced by ultrasound) for comfort as well as nourishment, i've read how heart rates lower breathings' slower and deeper ( better saturation of o's) seen in nicus. but in order to allow physiologic rather than artificial sucking/soothing "without wearing the new mom" out i suggest that dad (dad's better because his thumb's bigge,r kinda like a breast !) use their washed "count to 100 while scrubbing" thumbs (with the nail trimmed close) and flip the wrist (kinda like you're going to suck it yourself--tap the baby's bottom lip or chin until the jaw drops open wide--kinda like "a baby bird" or a "wide mouth bass" (dad's like that and can relate) "lay your nail bed down on the baby's tongue and lightly stroke the tongue, if the baby wants to suck, he will draw dad's thumb "all the way to the soft palate" AND THEY DO NOT GAG OR CHOKE. It amazes every one how deep they can take dad's thumb (to the first knuckle with EASE).....i have parents "finger feed" this way (and have for 3+ years) at our hospital and these kids, premies too! can open widely enough to some of the biggest/flattest/inverted nipples. look now at your thumb and see how close it is to the amount of breast a baby must take in when they do it right..... BETTER YET i have the parents trim the baby's nails (i do this service in the nursery & no miss cuts in 20 years) and help the baby suck on his whole clenched fist. you can elicit the same reflex response by tapping the baby's fist on the bottom lip--amazing ! i try to think how would a baby soothe himself if he lived in a time when artificial pacifiers were not mass produced, before early man could fashion tools. i'm sure they used hides, bones or river polished rocks, but if it was dark and you couldn't find a toy (like in the womb), what would you use if you were a bored or stressed fetus ??????? whatever you can get to stay in your mouth !!!!maybe thats why some baby's are tongue suckers, they are resourceful when they can't get their hand to their mouth... I tell parents to let their baby suck on their own fist, help them even. now look at a baby's profile when they are sucking on their whole fist. Looks like a baby correctly latched on ****see Best Feeding by Chloe Fisher CNM I've noticed that baby's who can latch onto a fist make GREAT NURSERS even on LARGE inverted nipples. Baby's can find their fists when everyone's asleep.... Lastly when any one says to me there's NO SUCH THING AS NIPPLE CONFUSION How come we get these babys who suck GREAT on a bottle or DUMMIE but refuse to latch on to mom or HOW ABOUT THE BOTTLE FED BABY that rejects ALL BUT ONE STYLE NIPPLE or PACIFIER! Any one who's worked any time in a nursery knows that some days a desperate dad comes up to the nursery BEGGING FOR THAT SPECIAL PACIFIER THEY DON"T SELL AT WALMART (ie ROSS ) NUK what have you...or the baby that CAN"T GET MILK OUT OF A HEALTHFLOW....Hmmmmmm I thought ALL BABIES SUCKED THE SAME yes i'm shouting i even know "BABY FRIENDLY" lactation consultants who trained like me at UCLA and Swear there's no such thing as nipple confusion...."DAMN semantics" either a baby takes it well or it doesn't...yes, some baby's are flexible just like some adults are and "some are not" just like some adults are inflexible . Problem is, babys don't have labels to which one is flexible...would a "caring nurse" who believes in choices, risk that any baby might refuse to breastfeed and be stuck with no choice at the breast because mom can only take so much rejection, when they have little (at best) support when they go home to a family that only knows how to bottle feed and use pacifiers ?