Devorah, You make an important point. Doing a suck exam without fluid flow does not give the information we need. Using some fluid (fingerfeeding, even if only with water) is important during a digital suck assessment, as many infants with good non-nutritive sucking skills have difficulty with nutritive sucking. Using fluid allows the LC to assess coordination of suck-swallow-breathe as well as sucking mechanics, which may be very different if all the baby is handling is it's own secretions. -- Catherine Watson Genna, IBCLC NYC [log in to unmask]