The development of sucking, swallowing and breathing patterns in healthy term breastfeeding infants

Vanessa Susanna Sakalidis

Research output: ThesisDoctoral Thesis

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Abstract

[Truncated abstract] For successful breastfeeding, the infant must not only remove milk from the breast, but also coordinate swallowing and breathing to allow safe transport of the milk bolus from the infant's oral cavity to the digestive system, all whilst maintaining good cardiorespiratory stability. Despite the sophistication of this process, our fundamental knowledge of suck, swallow, breathe (SSwB) patterns are restricted largely to bottle-feeding studies. Furthermore, controversy still exists as to whether infants primarily use either compression or vacuum to remove milk. Given that many women cease breastfeeding prematurely as a result of sucking problems, a clear and comprehensive understanding of sucking, and related swallowing and breathing patterns in the early post-partum period are essential to the provision of successful clinical intervention. The aim of this thesis was to clarify the mechanisms of milk removal during early and established lactation, as well as the development of SSwB, oxygenation and heart rate patterns across the first four months of lactation. The study population consisted of healthy term breastfeeding infants. To investigate the influence of secretory activation and birth mode on breastfeeding, sucking dynamics were measured using submental ultrasound imaging of the infant oral cavity. Measurements were performed during secretory activation (day 3) and again in established lactation during both nutritive sucking (NS) and non-nutritive sucking (NNS) in infants born by vaginal birth (n=15), and by caesarean section (n=19). To investigate the impact of vacuum on milk removal, synchronised submental ultrasound imaging, vacuum, swallowing, breathing, oxygenation, and heart rate measurements were made during NS and NNS. These measurements were compared for a breastfeed and a feed with an experimental teat that released milk only with vacuum (n=16).
Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2013

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