In my experience consulting with many yuppie career-oriented moms who largely refused cup/finger/syringe feeds and would have quit bf altogether, I *had* to learn how to help them bottlefeed in the midst of a bf problem (of many varieties). I will join Diane on her limb with the caveat that each mom and babe are individually assessed, not only for the underlying problem but also for the custom-tailored best solution. I have long ago (8 years or so) been rare among LCs by "allowing" (sometimes even suggesting - gasp!) a bottle with the following minimal instructions for its use: 1) Use the bottle at night preferably - quick and fast and everyone back to bed is the goal; Rationale: Moms cope much better by day with "teaching" a recalcitrant/problem nurser if she has had sleep by night. Also Dads are certainly more supportive if he sees his wife managing - I have seen men be more concerned over their wife's state of mind/energy than the baby's longterm needs for BM and insist on weaning otherwise. Baby is more sleepy at night and possibly less alert to the style of feeding. 2)Use the bottle to "teach" breastfeeding: Hold the baby close as for bf (and switch arms mid-bottle), tickle the lower lip, wait for the wide-O, reward the baby with something to suck and swallow (place the teat on the tongue and let baby close lips to start sucking), watch for the breathing pause, then tilt the bottle down (without removing the nipple from the mouth) to stop milk-flow until baby reinitiates the next suck cycle - I make *sure* Dads and Grandmas demonstrate this technique to me personally; Rationale: some learning seems to be readily adaptable, and baby can continue to work on responding to stimuli in a proper manner. 3) Breastmilk is the best to put in the bottle (Mom might pump during the day after feeds to create the nighttime stash)(if there is no BM, then ABM is the only acceptable alternative - ie, don't substitute glucose H20 or plain H20); obvious rationale. 4) (And probably the most significant reason for the huge success I have seen with this radical approach) I instruct parents that newborns "remember" the latch-on and suck/swallow of the *most recent* feeding (ie the "last" feeding). Therefore, if Dad gives a bottle at 4 AM and the 7 AM feeding will be at the breast, baby is going to remember "bottle" not "breast". So I warn mom about this. I suggest she get baby 15 minutes early at 6:45 before ravenous hunger hits, and take the extra time to "re-teach" the breast - first, she can express so the let-down is there, then she does a brief finger-stim until the suck is right (I teach her all this), then offer the breast in the usual manner. I remind her that it may take several latch-on attempts as the baby is literally switching gears. Knowing this - following a good night sleep - provides infinite patience and minimal frustration for her. The next feeding (9 or 10 am), baby "remembers" the 7:00 breast latch-on and usually does better, with reinforcement continuing through the day. Rationale: Start the feeding early while baby is still sleepy and/or not overly hungry helps baby get into a learning mode; telling mom she is a her baby's first teacher under special circumstances helps boost her confidence; pointing out *why* the breastfeed after the bottle feed is going to be awkward keeps the focus where it should be: on a learning infant, not on an "incompetent mom" (the assumed, and very wrong, conclusion otherwise). Also, I have used this information approach in the NICU to teach moms to teach their growing premies to breastfeed and it works extraordinarily well, considering it may not even be the same-time feeding every day that baby gets to directly nurse, or that mom will even have a competent LC nurse to assist her on her next visit. The result has been, and is, that the moms I consult with are delayed by 2-3 days for total breastfeeding, but with minimal fatigue and - bonus - their sanity intact. Plus I rarely have to use special feeding equipment anymore. I think, (emphasis intended) USED THIS WAY, bottles can be a sanity-saver, and a breastfeeding-saver, for the specific families who seem to need this approach. Additionally, picking up on the novice-expert thread, I know my style conveys enormous confidence that mom can succeed at bf - I have a very easy-going, relaxed, informational approach, and I ask questions and do LOTS of listening - most parents and babies will "tell me" what the best solution is, if I just listen long enough and then re-interpret for them what they already know, but didn't realize they knew (if you know what I mean!). Ever supportive of breastfeeding, Katharine