Anne, I hope you have read Mary Grace Lanese's (et. al) study in JOGNN regarding the improved breastfeeding continuation rates when babies were transitioned to breast from gavage rather than bottles. We have had the same experience in our NICU. Re: transitioning premies to the breast While cup feeding works well for babies close to term, I think our neonatal occupational therapist (NDT and SI certified) would drop dead if we tried to transition premies with a cup because it does nothing to teach correct jaw and suckling action in preparation for breastfeeding. Note: we don't use bottles either unless mom is not available and has requested it. Re: Indwelling naso-gastric tubes and breast feeding. A couple of years ago, I stuck a gavage tube down my own nose and taped it down for a day to see how miserable it was to eat with it in place. It was just awful going down and coming back up. But while it was indwelling ---- it tickled,......that's about it, and I have a fully developed gag reflex. Personally I think nasal oxygen cannulas interfere more with breastfeeding because they create a barrier under the baby's nose. That problem is solved pretty well by using a clutch hold, but I am always grateful when the baby can maintain oxygen saturation without supplemental oxygen. Nystatin for over a month? What for? Re: fortification of EBM revisited I am not a neonatologist or a neonatal dietician, BUT, after 30 years as an NICU nurse, I can say that routine long-bone studies on premature babies fed totally on unfortified breast milk HAVE shown evidence of rickets. My question is: Just because a baby does not have clinically obvious rickets, does that mean there isn't a problem? Are long-bone studies done on premies in Zimbabwe? Just curious. I'm not necessarily in favor of fortifying breast milk if it is not necessary, but I am definitely in favor of reducing any incidence of nutritional deficiencies from whatever cause when it is possible. Deanne *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html