I must input here as someone who was an OT in a NICU for over 5 years and as a LLLL for over a year now. As in every field there are very knowlegable OTs (or LCs for that matter) and there are some who aren't as knowledgeable. There are instances when oral stim can make the difference in a premie or full term baby who has sensory integration difficulties. I believe the breast is obviously the first choice but sometimes lighter or deeper touch is what a baby needs to understand what to do with the nipple in the mouth. And "ideally" all babies should know how to suck but they don't due to drugs, birth complications etc. For those OT/SPs using a bottle, maybe it comes from a lack of understanding of knowledge of breastfeeding. I believe all OTs or SPs could benefit from some lactation knowledge from LCs as I also believe some LCs could benefit from some knowlege from the OTs they work with. Each field brings a different perspective to a situation. We all want to promote lactation and help babies get the best. An OT referral doesn't need to be used in every instance, but referring to a good source can be invaluable. Jill Andrews OTR, CHT,LLLL mother to 4y/o daughter and 18m/o son Dh who is a mechanical engineer who "knows" the answers to most basic bf problems. PS. the EBM of the cotton swab is so the stim is a more positive experience. *********************************************** 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