Hi Jan and all, We call the nipple sucker an 'adapted syringe.' Among ourselves, we call it a 'nipple stretcher.' Mothers do not seem to object to the term, adapted syringe. We generally suggest that a mother start using it after delivery. I would not want any hint of nipple stimulation suggested by us as the cause of premature labor. We suggest a mother use it about 5 mins./ hour or so. She may elect not to use it at a time that she will be using the pump. She may use it just before nursing. We provide general guidelines; the mother plays with the adapted syringe and determines what works best for her. A problem we have found is the occassional well-meaning nurse who will use the device for the mother. I try to make it clear that the mother is the only one allowed to use it. She is the only one who can determine the appropriate amount of suction -- how much to stretch before any hint of discomfort. Hope this is helpful. Pardee H. HInson, MPH, IBCLC Charlotte, NC