1) Re: heating milk in a bowl of boiling water:  this is a safety risk in regard to 
the risk of scalding the baby.  Further, there is the risk of damaging and 
destroying some of the components in human milk by heating in a microwave 
or at otherwise high heat, such as heating in a pan of boiling water on the 
stove or in boiling water off the stove.  There is no need to heat human milk 
when then baby is nursing.  When nursing the baby, there is no risk of scalding 
the baby with milk that is too hot to safely consume, since milk directly from 
the mother's breast is at a pleasantly comfortable, safe temperature.  

2) My first child at age 4 months, circa 1973, repeatedly refused the breast 
after one bottle given to her by my mother-in-law; the bottle was given by my 
MIL without permission from me for her to do so.  To my knowledge, my 
daughter had been exclusively breastfed until that time, although after her 
birth at Portsmouth Naval Hospital in Portsmouth, Virginia in 1973, she may 
have been given bottled water for her first 24 hours.  It was hospital policy at 
that time to keep all newborns in the hospital's nursery for the first 24 hours.  
I had attended prenatal childbirth ed classes in which part of one class 
included info on health benefits of human milk ("breastmilk") as well as  
demonstrations and return demonstrations of cradle hold and maybe some 
other positions (I only mastered CH with that first baby).  The childbirth ed 
instructor advised us to tell the nursery nurses not to give our babies formula 
if we wanted to breastfeed, so that our babies wouldn't be too full to nurse 
(amazingly, when my daughter was finally brought to me at 24 hours of age, 
she immediately latched - - no nipple soreness at all).  I was 19 years old as a 
first-time mother, and although I was in agony over the separation from my 
baby during those hours, it didn't occur to me that I could demand to have my 
baby brought to me sooner or that I could leave the hospital with my baby 
AMA (hadn't heard of the concept then).  Four months later, as I offered the 
breast to my baby during her refusal, my mother-in-law commented in a 
condescending manner, "You're drying up."  I didn't have a pump and didn't go 
out and purchase one, became engorged, then soon went through breast 
involution following my baby's sudden weaning from the breast.  It was a 
confusing time - - thought about contacting the local LLLL (I had been to a 
couple of meetings by then) but was already devastated and couldn't bear to 
hear that I was "drying up" from one more person other than my MIL.  I felt as 
though I was too young to have realized that I was then depriving my child of 
nourishment re: "drying up", even though all her weight checks and 
developmental milestones had consistently been within normal ranges.  

Now many years later, my perception of her refusal is that she quickly 
developed a flow preference for the bottle re: first suck = immediate flow due 
to gravity as the bottle was tilted toward her.  Flow preferences are common 
across the lifespan, as adults often display flow preferences with various types 
of water bottles.  The athlete who is running or biking typically prefers a water 
bottle with the sports closure/cap in order to suck from the bottle for greater 
control during rapid motion, rather than drinking from a water bottle in which 
the closure/cap is entirely removed before drinking, for less control during 
motion.  The same athlete who is standing still during a break from a workout 
will likely prefer to remove the bottle closure for the most rapid flow, a faster 
and therefore more satisfying way to quench one's thirst.  Many children and 
teenagers seem to have energy to burn and often drink from bottles with 
sports closures, whether moving or standing still.  Most adults seem to prefer 
to drink from water bottles by entirely removing the cap to drink, although 
some adults prefer the greater control of the sports closure, regardless of 
whether they are moving or standing still.  

Motor preferences are displayed daily throughout our lives - - our motor 
preferences make a symphony possible (not everyone wants to play the string 
bass or the trumpet, but thankfully, someone does!).  A ball team also exists 
due to individual skills and abilities as well as personal motivations - - not 
everyone is skilled in pitching or in hitting homers or even wishes to learn to 
accomplish such feats.  It takes at least 10 years for an athlete to reach elite 
levels of performance, so surely we can give babies a little time to learn how 
suckle before their motor learning is challenged by other feeding methods!  

Even when such challenges actually occur, my perception is that older, skilled 
nurslings are not going to become nipple confused, as evidenced by their 
refusal to even attempt the latch - - as opposed to very young newborns who 
are profoundly neurologically wired to move toward the mother's breast.  My 
most frequent perception of older babies' refusal of the breast is that they are 
displaying a flow preference for an immediate flow, even if it's expressed 
mother's milk in the bottle (after all, many exclusively bottle-fed babies prefer 
certain types of bottles/bottle nipples, and older babies often display greater 
motor control with one type of sippee cup over another).  This seems to 
correlate with the common report by many mothers who have returned to work 
re:  frequent breast refusal within a month or two of going back to work.  
Today, many mothers have pumps and in such situations, often continue to 
express milk in order to continue to give mother's milk to their little ones, rarely 
seeking lactation care for breast refusal at later ages, as if the feeding 
difficulty is inevitable.  Is there a common perception among mothers that LCs 
and other lactation clinicians help only with newborn latch?

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