Debbie writes: I am a little confused though that you said you used supplimental systems (which we are not to supposed to name by brand name but you all know what I mean.) for helping babies with poor suck. Chele Marmet has made it clear on many occaisions that the supplimental systems have no role to play in helping a baby to learn to suck correctly. It's appropriate use in my opinion is extremely limited . At least in my practice. But perhaps not yours. Can you clarify what you meant here? ( I will be using the SNS term for ease, not for advertising) The LC who I work with (as well as other colleagues here in Sacramento) all use the Sup systems when appropriate. Why? BC some parents simply do not want to syringe feed. It can be difficult to master and do correctly, and it is time consuming. Chele has changed her views on the SNS type systems over the last few years and that is fine. I can see her point about how using a P Syringe (Periodontal Syringe) and finger feeding can train a baby to suck better than an SNS. BUT, we are back to what the parent will do and feels comfortable with. I feel that the tubing is a pain to work with, but quite frankly, if I needed to feed my baby, I would much rather finger feed with an SNS than with that darn syringe anytime. I did it with the P-syringe and I didn't like it at all. Now, I DO NOT make my own personal bias known to clients (that would be inappropriate), I give them a choice (or rather the LC working with them does). We show them how each system works and let them decide. I, personally, think it is possible to use an SNS to teach a baby to suck correctly whether on a finger or on the breast. It can be used to give a bolus (encouragger/treat) when the baby demonstrates proper suck technique, just as the syringe. The LC I work with has done this numerous times with numerous babies and has had many successes. She also uses the P-syringe with many successes as well. Just because Chele is Chele doesn't mean that she is always right. I love Chele dearly, and she is a friend of mine, but as in any profession, we don't always have to agree. She helped me out greatly with my major BF problems with my 2nd son (story #3 in my first post). I respect and admire her a lot. But that doesn't mean I will always agree with what the guru of BF says. There are, as I said, many uses for all the tools we have at our disposal. Each one has its place and we all need to keep our options open. Many times, if we just give a baby time, as Chris H has said, the baby will L-O just fine with no interventions. WHay be in such a darn hurry to get that baby L-O within the first few hours, or first 24? SOme babies need time. We as professionals need to know what to watch for and when to intervene. SOmetimes a baby with a sleepy l-o or a sloppy l-o will suddenly "get-it" on day 3 and do fine. But some folks want to hurry up the process and intervene with some tool. So, to end this rambling, I see a valid place for SNS's, cups, suck training, p-syringes, nip shields, etc. They all are appropriate in different circumstances. I have seen more than a few cases where the first try with an SNS (starter sys) got baby going just fine, so mom didn't have to fiddle with the shield and try to tkae it off mid feed, or risk her milk supply or baby becoming addicted. I am not sure I agree with a nip shield being appropriate for bubble palates, however. A babe with a bubble palate, in my experience, typically wants to stuff the palate with breast tissue. The key there is to convince baby to keep the nipple from being part of that tissue and learn to suck properly to aviod that. I just don't see a nip shield stretching back far enough to teach that to a baby. Now, I could be wrong, and I will be discussing this with my mentors here. The babes I have worked with with bubble palates, all had super-sensitive gag reflexes, so we taught mom and dad how to "suck train" with baby to get baby past that enough to where baby could take the breast in his mouth properly, thereby keeping the nipple out of that bubble, and getting it to the back of the throat where it belongs. BTW, to me, suck training IS mom and dad letting baby suck on their finger and mom and dad doing specific things while baby is sucking to "teach" baby to suck properly. Whether it be gently (pressure so light you hardly know you're doing it) pressing down on the back of the tongue to teach baby to not raise the back of the tongue up (thereby teaching them to keep that tongue forward in proper position), or any other specific movement of the finger to "train" the baby to suck properly. This is my version of "Suck Training". It is what I was taught by Chele herself. Many babies have been "taught" to suck properly by using suck training for a few moments and then immediately transitioning baby to breast while baby is "doing it right". Enough for now. My baby needs me! Jay Enjoying the discussion... Jay Simpson, CLE Sacramento, CA "No Miracles performed here, just a lot of love and hard work."