If a mother tickles with the teat, *waits*
>for a good gape, then puts the bottle *all the way in* so the baby's lips
>flange on the wide part, she's done a fair approximation of a breastfeeding
>latch-on.
>

It is my experience that the first thing the baby loses is the drawing in of
the breast.  Putting a rubber teat into an infant's mouth makes that drawing
in not necessary; and then the baby comes to the breast, makes a nice open
mouth, puts her mouth on the nipple and waits...One of the transition steps
I take is to have the mother put the teat just inside the lips and let the
baby draw it in, same with finger.

But-

The other maddening thing is that there are NO teats that are anything like
the mother's nipples that I see.  If there were one that was soft, floppy,
large, rather flat, malleable, slow flowing, and long, then I would have no
problem recommending it as in interim device. I won't hold my breath...

Do any of you remember the original orthodontic nipples? They were large
bulbous things.  I wonder if they were what the designer intended.  He was
an onthodontist who wanted his bottle-fed babies to get the same jaw
exercise that b'fed babies get.  Do any of you know if they were good? I had
one but never used it. When he sold his patent things changed a lot.

Last summer I was working with a premie and the parents were cup feeding,
beginning at four weeks, and the baby was feeding at the breast more and
more.  After the thread on nipple confusion and some highly experienced LCs
speaking firmly of rubber teats not really causing a problem, I questioned
my own experience.  (I'm here to learn.) When the parents asked if they
could give a bottle at night because it would assure more sleep, I said give
it a try.  Well, the baby took a giant step backwards.  It took about four
days to get him back to where they were. So I'm back to doing what works
(most of the time) for me.

I do know that cup isn't always effective either, but it has worked more
often for my clients than anything else. And until someone design's my
"perfect teat" then I will refrain from recommending teats.

Patricia Gima, IBCLC
Milwaukee