I have been lurking around Lactnet for several months and am finally ready to introduce myself and make a cogent comment. I am Linda Stewart, an RN working as a patient educator at Kaiser Permanente in San Diego. We have about 4000 deliveries per year. We have an 80% lactation rate at discharge (average 24 hours) It falls off dramatically by 6 weeks. We have a low cs rate but a high intervention rate with epidurals, forceps, suction, etc. I work with cup feeding when necessary --- whenever a baby passes 24 hours without feeding or is "on protocol", eg low blood sugar. It is the easiest and most babies take it quite well. ( If a baby must be supplemented with ABM and will suck, I will use a feeding tube device at the breast. That seems to be the least confounding intervention. .Of course, babies who suck have less need for the stuff.) If the baby won't suck, the cup seems to get the stuff in faster without sequella. Often, after a few full tummies, the baby will begin to wake and seek the sucking and will latch well. I, too, have found that finger feeding makes the baby seek the rigid form into his mouth in order to suck. If mom has soft, short nipples, this transition is a bit more difficult than if the mom will long, firmer nipples. I resort to this if I can't get the baby to swallow the cupped in ABM. Some babies need to learn to suck and the cup doesn't help with that. Then, I will use the finger feeding routine to teach the suck. I seldom have to use this before 24 hours because most babies will snap out of their sleepy transition soon after this time period. I hope my experience will help any of you still learning these skills. For further info, please e-mail privately and [log in to unmask] Back to lurking.