I think this is indicative of a problem that exists with ANY artificial feeding method. Infants can become 'confused' with any of the alternate supplement processes. As the 'technology' of breastfeeding gets more widely known there is an increasing problem with people not recognizing that anything other than the breast has inherent risks. It is a matter of choosing the least risky option. In some cases that is gavage feeding, in other cases cup feeding. Sometimes it is a periodontal syringe/finger feeding etc. Sometimes it is even (gasp) bottle feeding. The point is to chose a method that is effective, do-able by the parents or facility, and get the baby to the breast as soon as possible. I have been increasingly concerned as I hear partially informed and well meaning advocates who end up promoting one method as though it is the be all and end all. "THIS is the way to avoid confusion". No magic wand exists. I personally often suggest cup feeding, but with the clear understanding that 'cup confusion' is real and possible. I also recommend supplementer systems (of a variety of brands) but how many of us have seen those smart little tiny people turn towards a tube fully aware of where the milk is actually coming from. It is something that can be and is dealt with. We must recognize that the only thing the same as feeding from the breast is 'breastfeeding'. We need to accurately inform parents of the risks/benefits of the alternative methods of supplementing and why we are recommending one method over another. Then let them decide what they wish to do. ----"Without interest and passion, nothing great has ever happened in history" G.W.Hegel Rhoda Taylor, B.A., IBCLC ph. 604 748 4945 3346 Glacier St. fax. 604 748 2743 Duncan, B.C. Canada e-mail. [log in to unmask]