<<The one difference between what went on in the NICU with continuous gavage feedings and bottle feeding breastmilk, is that the saliva mixes with the bottlefeeding breastmilk. This does make a difference. The saliva begins to break down the milk and the bacteria count will increase.>> Assunta, I know this is the theoretical problem with this, but in reality I don't think it is. It's not like the kid is drooling into a glass or something--I doubt a lot of saliva gets in through that little hole in the teat when the milk is coming the other way. And in real practice, over the years I've had hundreds of mothers ask this question, I've told them what I told you, and I have NEVER had a mom report a problem with the milk spoiling. And like somebody else said recently, you can smell it if it does. Becky Krumwiede, RN, IBCLC, Appleton, WI [log in to unmask] or [log in to unmask]