I have used finger feeding over the past couple of years with good outcomes, I might use an SNS on the rare occasion that I think the parent might have to continue the practice at home . Usually, though, I use a small feeding tube and a 35cc syringe with approx 10-15cc of ebm or abm in it. I've foung that if I use a smaller syrings, the baby can't control the feeding,and I do not like pushing the milk into babe's mouth. I'm very concerned about aspiration. ( For whatever reason the baby doesn't seem to have much success with a 12cc or 20cc syringe.) I haven't had a problem with nipple confusion in these babies, thus far. Perhaps it's because we use the technique rarely and I believe the parent should be the one to feed the baby this way-- not me. I do like to be avaiable to them to assist and teach as babe feeds. Most babies will finger-feed when they don"t seem able to suckle at breast ( those poor little ones who have had tough mity-vac deliveries don't seem to awaken for much of anything the first 12-24 hours!!) Many babies will finger-feed once, then be ready for the breast within the next few hours. Oh, for the joys of gentle birth! Susan Wirtjes RN IBCLC from Susan in Iowa (is this heaven?) "What you permit, you promote"