Karen, Thanks for the reference on epidurals - I just couldn't get it right and couldn't find it in my file of articles labeled "articles" (One would think after 10 years of private practice one would get organized, right? Wrong). I do know I have it somewhere.... Lisa, I think the periodontal syringe is about 12 cc - and you're right, it is easier to get than the others. Works fine. I understand the concern about using an altered pieced of equipment for something for which it is not intended, but a) necessity is the mother of invention and b) in some of these cases, if we don't do it, nothing will be invented. How do we think the lactaid/SNS came into being? The Starter SNS was a result of using what I term the "poor man's supplementer" which was (and still is) a 36 inch feeding tube (5 fr) attached to a syringe with the plunger pulled out. ANYTHING, if not used correctly can cause damage in one way or another. Our responsibility is to carefully instruct. Even pumps, if used incorrectly, can cause tissue damage. (Esp. those little hummers made by the formula co). Marie, I was going to comment on the breast phobia, and Karen beat me to the punch about babies that are deeply suctioned or cords are visualized with a laryngoscope and then plopped on the mom's breast with no thought to the consequence. That was one of my terribly intractable ones. I'll be interested in Heather Harris' talk at the ILCA conference on 'rebirthing' (no, it isn't the new age primal scream thing - it has to do with the bathtub and breastfeeding :) ) Another point is the well meaning but the mistaken idea that we can force the baby on the breast. One of the formula co literature states that the best time to put the baby to breast is when he is crying because his mouth is open WIDE. (Right.) His tongue is up, protecting his airway, and we are trying to shove him on the breast. Do we wonder the babe has a problem? I think your point on reintroduction to the breast slowly and calmly is great. My letter to the pump companies will go out today.... UNITED we stand! Jan B.