Sharon, our NICU is just beginning to allow cup feeding as an alternative to bottle feeding for breastfed premies.  I just gave a presentation a couple of weeks ago to our docs and practitioners.  Now our breastfeeding committee has the awesome job of inservicing 150 nurses for this skill!!!  I will be glad to fax or mail a copy of the protocol to you if you want to email me privately to give me your fax or snail mail address.  I will also mail a copy of all the references that I used.  Hopefully, you can get these articles copied for you by your hospital library.  If not, let me know and I will copy several of my best articles and snail mail them to you.Sandra Lang's articles are the best I've found for someone who is experienced with cup feeding. She has cup fed premies as young as 30 weeks and they have tolerated it well without oxygen desats, and it was a positive oral experience for them vs. a gavage tube.  She states in her email to me that thousands of babies in the UK have been cup fed at different hospitals and their breastfeeding rates are dramatically increased.  In one study of hers that I read, the rate of exclusive breastfeeding at discharge for cup and breastfed babies was 90%.  For bottle and breastfed babies it was 63%  (which is still better than our rate of exclusive breastfeeding at discharge).  It should be individualized according to baby's status and abilities.  If you find that a baby is not tolerating it, you stop... same as you would with a bottle feeding. I don't know if they have had earlier discharge dates in the UK with cup feeders.  At our hospital, we already discharge so early that  the docs probably would not consider discharging any earlier even if a baby is feeding well.  We actually have discharged a few at 1600-1800 grams.  A lot depends on whether or not the baby is IUGR.  An IUGR baby might have to be 42 or 43 weeks by the time they reach a wt. of 2000+ grams sometimes.
Look forward to hearing from you.

Dani Hudspeth BSN, RN, IBCLC
[log in to unmask]