To the Editor.—

I wish to comment on the article "Single Daily Bottle Use in the Early Weeks Postpartum and Breast-Feeding Outcomes."1 Several of the conclusions of this article contradict what I see in clinical practice as a lactation specialist. The selection and definition of the sample groups puzzle me. Specifically, there is no totally breast-fed group. This is a design flaw that many breast-feeding research studies exhibit. An infant being fed up to two bottles a week and infants fed by bottle in the hospital are not totally breast-fed and have experienced the use of an artificial nipple.

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