MECHANICS OF BREASTFEEDING NEWBORN
Category: Child Health
Abstract : mechanics of breastfeeding Understanding the actual mechanism of how babies
get milk into their bodies is important. Suckling and breastfeeding often are
areas that are taken for granted because of their seemingly instinctive nature.
However, the mechanics should not be forgotten or deemphasized because they are
essential for a successful and uncomplicated breastfeeding experience. This
mechanics of breastfeeding
Understanding the actual mechanism of how babies
get milk into their bodies is important. Suckling and breastfeeding often are
areas that are taken for granted because of their seemingly instinctive nature.
However, the mechanics should not be forgotten or deemphasized because they are
essential for a successful and uncomplicated breastfeeding experience.
This
understanding is helpful in ensuring the use of proper breastfeeding
technique.
Initiation of the breastfeeding cycle
When breastfeeding
begins, the nipple, surrounding areola, and underlying breast tissue are brought
deeply into the infant's mouth, with the baby's lips and cheeks forming a seal.
During feeding, the suction created within the baby's mouth causes the mother's
nipple and areola mammae to elongate to 2-3 times their resting length and to
form a teat. The nipple and areola extend as far as the junction between the
baby's hard and soft palates. The baby's jaw then moves his or her tongue toward
the areola, compressing it. This process causes the milk to travel from the
lactiferous sinuses to the infant's mouth. The baby then raises the anterior
portion of the tongue to complete the process.
Afterward, the baby
depresses and retracts the posterior portion of his or her tongue in undulating
or peristaltic motions. This motion forms a groove in the tongue that channels
milk to the back of the oral cavity and stimulates receptors that initiate the
swallowing reflex. This backward movement creates a negative pressure, allowing
milk to travel into the baby's mouth. Throughout the suckling cycle, the nipple
should not move in the infant's mouth if it is positioned
correctly.
Swallowing during the breastfeeding cycle
When the volume
of milk is sufficient to trigger swallowing, the back of the infant's tongue
elevates and presses against the posterior pharyngeal wall. The soft palate then
rises, closing off the nasal passageways. The larynx then moves up and forward
to close off the trachea, allowing milk to flow into the esophagus. The infant
then lowers his or her jaw, the lactiferous sinuses refill, and a new cycle
begins. A rhythm is created in which a swallow typically follows every 1-3
sucks.
Differences between suckling and sucking
Distinct differences
between suckling from a breast and sucking from an artificial nipple are
important to note. Suckling from the breast is an active process that involves
participation of both the mother and her infant. In contrast, bottle-feeding is
a more passive activity that results in the creation of a partial vacuum in the
infant's mouth through sucking. The artificial teat taken into the infant's
mouth has a distinct oral/tactile stimulation. When an infant sucks on an
artificial nipple, the nipple fills his or her mouth and prevents the
peristaltic tongue action that occurs with suckling at the breast. Milk flows
from the artificial nipple into the mouth without tongue action; flow occurs
from the rubber nipple even if the baby's lips are not sealed around the nipple.
Because of these differences, an infant is more likely to have a desaturation
episode during bottle-feeding than during breastfeeding.
Phenomenon of
human imprinting Lawrence and Lawrence discuss the phenomenon of human
imprinting or stamping, which occurs early in the postnatal period. Comfort
sucking and the formation of a nipple preference are genetically determined
behaviors that affect imprinting to the mother's nipple. The baby's initial
recognition of his or her mother involves the distinctive features of the
nipple. If an infant who is learning to breastfeed receives supplementation via
a bottle or a pacifier, the nipple-recognition signals are mixed. Although some
dispute the existence of nipple confusion, numerous documented cases support its
existence. Certainly, studies have shown that supplementation and the
introduction of a foreign nipple, such as a pacifier, are associated with
decreased rates of continued breastfeeding.
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