I'd like to add a few comments to the tubing supplementer vs bottles to supplement discussion, which I very much appreciate everyone's input on. I like Jack Newman's tubing in bottle supplementer, but if the baby can't latch, the tubing supplementer is not going to be very useful. As has been already mentioned, the mother may choose the bottle to supplement. Here in Mississippi, bottle feeding far surpasses breastfeeding in the culture.  I personally believe that time spent in the consultation is longer, and follow-up would be more necessary with the supplementer. This is not always possible with staffing shortages, and with mothers living in rural areas where access to the lactation consultant is not easy. We are very lucky to get in one follow up visit after hospital discharge, which may be the first time a problem is identified. Also, in my community, the pediatrician directs the care of the child, the comfort level of the pediatrician in the method of supplementation is a factor. One more thing, the cost is a huge factor in the population I work with. I know this may sound like a cop-out to some, but there it is.  Laurie Wheeler, IBCLC, MN, RN Mississippi, middle south USA 
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