Geoff: First, I think it is wonderful that your are not blindly accepting of an idea & really want to explore its potential! You are forcing all of us to really look long & hard at what we practice and that's great! You state: <<Fluoroscopic studies also show that the nipple (since it is vey flexible/supple) is drawn to the oropharynx, breast milk rarely enters the oral cavity. It is expressed into the oropharynx where the (as yet to bew fully understood) swallow occurs...Cup feeding goes against this paradigm as it assumes the infant can control the bolus orally which goes against what is known about flexor skills (again Morris and more if you wish).>> Bottle feeding ALSO goes against this paradigm! You are onto something here - we REALLY need to look long & hard at the safety of bottles - I am speaking outside this group, of course! We already do that SOOO well! You also state: <<Therefore, an infant does not lap. (Studies of infant -v- dog feeding have been done, no references off hand).>> I had to chuckle at this mential pic this created! But all funnies aside, they indeed DO lap it up, in spite of what this research might have said! I would encourage a visit to an NICU that cupfeeds their wee ones! What a wonderful sight it is! Also, I wish you would dig out your references for us - we are a hungry lot for such stuff! <<I am open to cup feeding but I want definitive proof of it's safety - long term safety as well.>> And we hunger for this in regards to bottle feeding. We know what it does to O2 sats & heart rate - we need to really raise the consciousness of healthcare providers regarding these concerns. Since cupfeeding is certainly not as widespread in the US as bottle feeding, I should think it would behoove us to do the bottle feeding safety studies as a priority - or better yet, a comparative study -breast, bottle, & cup - one that also differentiates between use of artificial stuff & human milk! Cup feeding is viewed by some as a less invasive means to alternate feeding - it is a baby-led activity. And though not for every baby in every situation needing an alternative feeding method, as Barbara beautifully articulates, it is a worthy option. <<What is more important infant health or cupfeeding to avoid "nipple confusion" (I hate that term).>> Geoff, I don't think there's a soul on the list who would put nipple confusion above the baby's health. I'm sorry you feel uncomfortable with that term. In the real world is is there & a very real threat to the bfing relationship as it is meant to be. It never takes precidence over baby's health, but it is worthy of consideration in the individualized plan of care for babies needing anything but the breast. <<And I have seen PhD's names attached to studies that "prove" infants can cup feed as young as 30 wks AGA. Nonsense!!! Do you know what infant lung maturation is at 30 wks? Medically assisted for short. You orally feed a 30 weeker via any method and your risking it's longevity if not it's life. Again the research is out there.>> Here again, I kindly request that you actually state those studies to which you are referring. It helps us a great deal to sort through this or any other issue & try to make sense of it. When you say orally feed, do you also include bfing? Sorry this is so long but you've REALLY made me think - & on a Friday that can be a challenge! Moving back into my weekend mode... Debbie Shinskie RN CES IBCLC in Millersburg, PA, USA [log in to unmask] http://www.epix.net/~shinskie/ "The cure for anything is salt water - sweat, tears, or the sea." -Isak Dinesen