There are lots of ways to skin a cat. (Just a SAYING. We don't even eat our chickens. When they get old and die, we bury them!) Anyway, the issue to me isn't so much can you get food into a baby via spoon, cup, dropper, finger-feeding w/ syringe, feeding tube or bottle. It's clear that you can, and throughout human history people have. There is (or was) a very instructive display of archeological artifacts at the Children's Nutrition Research Center in Houston. All of them were infant feeding implements of one sort or another dug up from pyramids, mounds, tombs etc. The question I have is: Is there one way or another that is preferable if the infant is temporarily prevented from breastfeeding? I have seen plenty of babies who I have managed with finger feeding become just as 'nipple confused' as babies who have been getting bottles. A long, formed object was in both cases being pushed (rather than pulled) into baby's mouth, and milk was then delivered. I've had babies with strong sucks pull the milk out of a periodontal syringe without my pushing on it. But what is the difference between that and their sucking the milk out of a nipple chamber? Is there a difference? Neither is like breastfeeding. Now, don't consider this a rationalization for using bottles. Just a desire to initate a discussion. I still finger feed some babies. I also cup or spoon feed. Some I bottle feed. It depends on the baby's problem, the parents desire and willingness to learn a method, and how much time we have to play with. Cups and spoons don't present the problem of conditioning baby to expect a formed object to be pushed back far enough to trigger a palatal cue to suck. However, I can't consider them some sort of holy grail solution. For instance, there have been a few lactnet posts describing babies who never had bottles, only cup and still wouldn't go to breast. That has certainly happened to some of the babies I've used cup feeding with.( Generally I then resort to a silicone nipple shield and gradually wean off it.) Cups are just one more way you can try to get food into a non-nursing baby. I would really like to see cup feeding not become the new dogma. I think hospt. policies should focus on inclusion of cup feeding. Pardee's post was useful there. I don't think that everyone should now decide that cup feeding is somehow the only pc (politically correct) way to alternatively feed. For one thing, I am not aware of any large body of clinical work that supports any method of alternative feeding as measurably better or worse in terms of how successful it is in preserving breastfeeding. (There is work, of course, describing adverse effects of early bottle initiation. There is also at least one paper that describes early bottle use as not particularly a problem, although this was occasional use in well babies -- not the population I am considering. That ref is: Cronwett, et al: Single Daily Bottle Use in the Early Weeks Postpartum and Breastfeeding Outcomes. Pediatrics, 1992; 90(5):760-66.) I would be interested in hearing if anyone knows of work that goes beyond HOW to alternatively feed. Specifically I am interested in outcomes: adverse as well as beneficial. I'd like to see some of our research oriented lactnetters consider soliciting data from those of us in clinical practice about outcomes from interventions involving different alternative feeding methods. Obviously there would need to be some sort of design that allowed for confounding variables to be sorted out, but between all of the babies we see, perhaps we could begin to gather some info.that would help us develop rationales for selecting the most appropriate feeding method for babies in various situations. For instance, one of my pet theories is that if mother has inverted nipples, her baby esp. should be managed without exposure to bottle teats. This is a set-up for breast refusal. I'd probably also avoid finger-feeding this baby as well. Can you tell that I have a 3 day weekend and time on my hands, or what? Happy New Years to All! Barbara Wilson-Clay, BSE, IBCLC priv. pract. Austin, Tx