You might check with the nursing licensing body in your jurisdiction. In Ontario, the college of nurses has very definitely stated that giving supplements without *informed* consent constitutes professional misconduct, *even* if the supplement has been ordered by a physician. Now, I wish I could say that this has made a huge difference (I doubt it), but it is a weapon which can be used, and at least some nurses will think twice before supplementing. Secondly, policy and procedure can include using alternative methods first (which includes improving latch and positioning *before* supplementing), before giving bottles. The bottles are given because they are easy for the nurses. Make it more difficult to supplement, and maybe something will happen for the better. Of course, if policy is not backed up with sanctions for not following policy and nice strokes for following policy, everything is useless. Jack Newman, MD, FRCPC