Imprinting is a phenomenon which occurs in many young animals after
hatching/birth.  During this sensitive phase, they become conditioned to
stimuli, and their experinces begin to define what is "normal" to them.
Thus, if a normal stimulus (like the impression made by a soft, maternal
nipple which baby sucks in) is replaced by a larger, stiffer, longer object
which is poked in, the "Super-stimulus"  replaces the baby's normal
expectation with a larger-than-life expectation.  This change in the normal
order of things is part of how I describe "nipple confusion."  Mavis Gunther
first decribed all of this in the Fifties after listening to Conrad Lorenz
talk about imprinting in birds.

 Finger-feeding, bottle feeding, it's all about the same if you are talking
about super-sign stimuli..  Not to say that finger-feeding and bottle
feeding are evil.  Sometimes a baby comes along who is not in a normal
state.  This baby may be premature, ill, neurologically affected in a
temporary or permanent way, drug affected, or very malnoursished.  All these
babies must be fed asap, and it is much less important to quibble about the
means of feeding than it is to feed them.

  The selection of the mode of feeding should be intentional and take into
account numerous factors.  If the baby only needs a bit of a jump start, I
use a spoon.  I find spoon feeding easy to handle for the thirsty or sleepy,
hard to rouse baby who just needs a sip to get going. To spoon feed for any
lengtht of time would be tedious and pointless.  I seldom cup feed because I
am not aware of any particular evidence that it encourages the kind of
tongue patterning which will lead to good breastfeeding technique, and
because I am concerned with aspiration resulting from my poor cup feeding
technique. If the delay getting baby to breast is likely to be lengthy,  I
like bottles because they promote central grooving of the tongue, and slow
flow nipples can assist in a controled flow rate suitable to some babies
with respiratory problems.  Also, they are easy for parents to use.  If the
baby can feed at breast, an SNS may be a good bet.   Any non-nursing baby
should, of course, be pacified or at least held close to breast during every
feeding, and when the baby is able to be transisitoned to breast, various
methods are used, again, depending on the baby's condition, capabilities,
and preferences.

  Nipple confusion is not normally a permanent condition. Behavior in humans
can be unlearned, and re-learned.   It is relatively easy to overcome in
most children providing parents haven't been frightened to death by
propaganda that it is irreversible. Still, all of us have seen  babies who
could never be brought back to breast.  Sensory defensiveness of the infant,
low milk supply, and parental ambivalence are the primary issues in the
cases I've observed where baby couldn't be brought back to breast.

It seems counter-productive to me to villify any safe  method which works to
nourish an infant so long as the lactation consultant has a reasonable plan
to protect and preseve breastfeeding.  People develop methods which feel
comfortable. In the absence of real evidence to the contrary,  I don't
particularly dictate the methods providing the practicioner has a clinically
based rationale and is following up to make sure they have good outcomes
from the rationale.  Plans which never work and a whole slew of babies who
wind up weaned dictate a return to the drawing board and a re-assessment of
methodology.

Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html