Successful transition from tube feedings to breast feeding can be challenging. Skin-to-skin care begun as soon as the baby is stable improves hemodynamic stability without increasing energy expenditure.Non-nutritive sucking (mother pumps first and then places the baby to the breast) can be attempted as soon as the baby is extubated and stable with success noted as early as 28 weeks corrected gestational age.Most premature infants can begin nutritive sucking about 32 weeks gestation. Assistance from an experienced nurse or lactation consultant is invaluable. Positioning that supports the mother’s breast and the baby’s head and neck are essential with the cross-cradle and football holds most effective. Early use of nipple shields increases milk intake and duration of breastfeeding