I was interested to hear Pamela express the idea that,in some cases, bottles
are the most efficient delivery method of getting food into some non-nursing
infants.  As these infants grow and recover from the original problem which
kept them from breast, I too have found that with a persistant approach,
they can be transitioned back to breast.  I think people give up the hope of
nursing too easily once bottles are introduced.  I hear mothers say over and
over again:   "I feel as if I need to make a decision to do it one way or
the other.  I'll feel at peace once I decide."  The logic of this baffles me
seeing as how humans often are quite comfortable with multiple approaches to
the same task.  Since it is rather irrational (tho common) I chalk it up to
post-partum insanity. When I point out that there is no reason to make a
decision on anything right away, and that the baby will probably do just
fine if given time to recover, often moms will agree to cont. pumping, and
feeding expressed human milk by bottle. This is easier for a lot of moms
than cup, not that much different from finger feeding, and many moms will
not use feeding tube devices.

 I totally agree we need more discussion of the term "nipple confusion."  It
is a concept that is poorly examined, not well understood, yet it is such a
part of our mythology that we ascribe many behaviors to it.  Felicity
Savage-Kings wonderful book has a lovely graphic which points out one of the
real risks of teat exposure which is the tendency to position baby on the
breast as you would on a bottle, which contributes to a wide range of nipple
problems and poor breast drainage, low intake, etc.

Please understand that I do not favor using bottles casually in the early pp
for babies who are capable of nursing.  It is essential to avoid iatrogenic
problems and babies should imprint on mother at first feeds if at all
possible.  But I see babies go to breast a month to 6 weeks pp and learn to
nurse.

Barbara Wilson-Clay, BSE, IBCLC
priv. pract.
owner LACTNEWS On-line:  http://moontower.com/bwc/lactnews.html