Nursing Mothers' Counsel, which i was once briefly associated with, will tell mothers to introduce a bottle at 3-4 weeks rather than 5-6 because there is less chance of refusal. i no longer have the material that may indicate the source for this, or if it is just opinion. in practice, it seems that the bottle is more easily accepted at the earlier time. the primary problem i see is mothers sent home from the hospital with a pump or instructions to immediately get a pump, and then to start pumping, with the inevitable nipple confusion resulting. i spoke to a mother recently whose health care professionals were aware of nipple confusion, but insisted that since her baby was a "strong sucker" it would not be a problem. the baby was "strongly" nipple confused at five days. the breastfeeding answer book (new edition) does state, pg. 199, "delay introducing a bottle until the baby has been breastfeeding well, ideally for at least three or four weeks," obviously addressing the same problem of early bottles. also, babies with problems need to overcome them and then wait the three or four weeks. it seems to me - or am i just naturally suspicious? - that the response to increased interest in breastfeeding is to introduce a machine dealing with breastfeeding rather than the machines of formula feeding. later the bab states that babies will accept a bottle "easily" at one, two, or three to six months and cites a study (pg. 211, new edition). aloha from winter wonderland, that's not snow, just my quilt batting spread out over the yard, denver, carol brussel lll etc.