When a baby refuses the breast, I often manage to help the mother to get the baby on well simply using good positioning and a good latch. When this does not work, especially in the first days, finger feeding is quite helpful, but it needs to be done right. Finger feeding is not to be used after 30 minutes of struggling to get the baby to the breast and then offering finger feeding as a feeding method until the next try. Finger feeding is best used to prepare the baby to take the breast, by settling him down a little, getting him sucking right, and then, after a minute or two of finger feeding trying him back at the breast (see Chloe Fischer's approach in Bestfeeding). Finger feeding can be slow, but in the first few days, babies don't usually drink much, and it is acceptable. After that, if it is slow, then finger feeding can be used to prepare the baby for the breast and if that does not work, cup feeding to finish the feeding. If necessary, the bottle can also be used, because finger feeding can be self defeating. If it takes a long time, the mother will not have time to maintain her milk supply by frequent expression. The best guarantee of the baby eventually taking the breast is the establishment of a good milk supply. Jack Newman, MD, FRCPC