The ongoing discussion of use of alternative feeding methods is an healthy one IMHO. in many posts, however, I see the mother's concerns regarding use of alternatives but no mention of the baby and what is in the best interest of the baby therapeutically. We are lucky that we live in an age where we have so many options, but our choice of which option to use must consider the goal of getting the baby back to breast with as little intervention as possible. For one baby, a bottle may be the right approach but for antoher, finger-feeding may be the right approach. And, yes, what is acceptable to the parents should be taken into consideration. In the absence of research regarding alternative feeding methods, we have to make decisions based on what we clinically observe to be productive. The definition of productive will change for each LC because so much of what we do is theoretical at this point. i am disturbed by the lack of a solid theoretical and research-based orientation of the discussion. i see much opinion, but it seems to be not very well thought through. At least from the infant's perspective. We know what constitutes proper sucking and milk transfer, We know what constitutes proper infant organization. We know what factors influence a woman's ability to commit and stick with breastfeeding. Why don;t we consider what we know and put alternative feeding into that context. As a lactation therapist, my goal is to get a baby to breast in as timely a manner as possible with as little intervention as possible, and ensure that the baby is going to be well organized and able to optimally trasnsfer milk. I continue to guide therapy until that goal is achieved. In the process, i do not want to stress out the family. It is within this framework that i make decisions about what approach is going to work best, partnering with the family in that decision-making process. But sometimes, the use of a specific tool over another can't be left up to the mother becuase a baby indicates with their behavior and feedback that the tool of her choice is not the best one for him/her. It is then my job to educate the motehr as to why a certain approach is optimal. i am far better able to get most complex situations nicely resolved when working from this philosophical construct: much more than ever before. Off my soapbox now. Alison K. HAzelbaker