I have several comments about the post from Carol S> about when to introduce a bottle to a BF baby. First I have to say that I've tried to access this from the archives to have the actual words in front of me but could only find Carol Bs post, which I had no problem with. If I misquote something I apologize. If a baby is "1,2,4,or 6" weeks old , then it may happen that we are telling a mother that it is OK to intro a bottle to a 1 or 2 week old baby just because for the FIRST time the baby had been "latched on and you won't remember putting him there...That's the day (when you have both gotten so 'good' at bf that it doesn't take any conscious effort on your part) to introduce a practice bottle." I have a few concerns about this statement. If we intro a bottle the first time this easy/automatic latch occurs then we have not "established successful BF". To establish means to make permanent, stable or secure according to Webster, and doing something (no matter how easily and subconsciously it is accomplished) for the FIRST time does not mean it is "established" By definition established means stable, and this means over a period of time, not in one instance. This baby could still go on to become nipple confused and this is not something to risk lightly. The other problem I have with introducing a bottle the first time, or even very soon after, BF seems to be going smoothly is this: bottle feeding is not a refinement or progression of nursing at the breast. It only makes sense to move from breast to bottle in rapid succesion if these skills themselves are related, building blocks or refinements, but they are not. Although both are feeding skills, they are very different in timing, muscle use and coordination, and at times they can be contradictory as in the case of proper tongue participation. Why would we teach our children to wheel a wheelchair simply because they've just learned to ride a bike? Why do women need our "OK to consider leaving the baby with a bottle of milk instead of her on occasion?" We provide moms with the information they need, if they want to go out we explain the options on how to go out. If this is a baby who is not "out of the woods" in terms of what we know about nipple confusion, we tell her in a sense it is not OK (without risk) but if she chooses to do it we help as best we can to prevent problems. We offer choices, delay the outing, take baby with you, take caregiver along to watch baby between feeds, use alt, feed methods, use Avent (or whatever your experience tells you to suggest), or give possible indicators to look for possible NC if she goes out anyway. She doesn't need our permission, only our support and our knowledge. Why do we suggest to intro a bottle simply because "the fun part of nursing" has arrived? What's about finally taking the baby out with family for dinner and enjoying being able to nurse discreetly in the restaurant? Isn't that what the fun part is, having gotten to the stage where nursing is easy and natural and non-confining - when we don''t need to sit on the couch with two pillows and our shirt off to watch every attempt the baby makes? We need to remember that this is a bottlefeeding culture and when we suggest that she will want to intro a bottle, we are not being fair.,Stepping back, asking open-ended questions about her plans in the upcoming weeks and months gives her the chance to decided if SHE want/needs this baby to take a bottle. We can provide anticipatory guidance on how family members can be involved and helpful, including burping, bathing, snuggling, carrying, feeding Mom, changing diapers and choosing clothing, and the eventual intro of solids- an "honor bestowed" on my mother-in-law. Just because a relative makes noises about wanting to do something ( bottlefeed ,in this case, or offer solids, have a sleepover, buy a toy gun,etc.) doesn't mean the mother has to say yes. Sometimes she will delay sometimes she can say no. We are empowering her to make her own choices based on good information. Since new mothers can be so fragile, we need to be sure that our suggestions about the "best "time to intro a bottle do not erode the mothering style she is cautiously building, which may not have included bottlefeeding as a necessity. If we assume she wants to use bottles, we do her a disservice. Perhaps you only have this discussion after you ask the open-ended questions, and offer all the appropriate, individualized options. I am glad when mothers are able to alternate breast/bottle early and without longterm problems if they need this option, but it is only appropriate to tell moms that MOST babies cannot do this at one or two weeks of age,.Since they don't come with labels designating "easily nippleconfused"or "NC Resistant" isn't it best to err on the side of caution as much as possible? Every woman working with BF moms has a great individualized bag of experinces to share. I am interested to hear other opinions/experiences on this subject. Do you think there is anything to the idea that an LC who recommends bottles earlier also gives a mother confidence to work out any minor flags of NC after intro of a bottle at 1 or 2 weeks so that even if it seems to be happening it never spirals out of control and becomes problematic? This is a phenomenon worth exploring. Judy Fram, Brooklyn, NY