Ultrasonic study of sucking and swallowing by newborn infants.
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Deglutition↗
Biomedical subjects
M W Woolridge
Publications and source records attributed to M W Woolridge.
Indirect test weighing: a non-intrusive technique for estimating night-time breast milk intake.
Indirect test weighing (ITW), for estimating night-time breast milk intake, is based on separate weighings of mother and infant before and after night-time sleep. Weight changes due to the exchange of milk overnight are reciprocal, so that if all other sources of weight change (eg, urine loss, supplementary fluid intake) are either controlled or measured, the difference between the mother's overnight weight loss and her infant's overnight weight gain represents their combined net evaporative water loss (EWL). The proportion of the combined EWL due to the infant is partitioned out as a function of the relative metabolic body sizes (kWt0.73) of mother and infant, and added to the infant's net overnight weight gain to provide an estimate of night-time breast milk intake. Validation studies, conducted in Northern Thailand, in which ITW was compared with direct test weighing (DTW) at each night feed, are reported for 13 infants over 3 nights at 5 d of age, and for 19 infants over 2 nights at 6 weeks of age or more. The regression equation for estimated milk intake against measured milk intake across all ages was y = 0.988x + 2.75, r = 0.927, n = 69 with 95 per cent prediction intervals of +/- 36 g for a range of intakes of 0-250 g. Rigorous control of data collection and taking account of the infant's age suggest that the prediction intervals for individual estimates can be improved to +/- 18 g at 5 d, and +/- 27 g at 6 weeks and over. Theoretical aspects of the relationship of EWL to body weight are discussed with a view to optimizing the accuracy of the technique.
Body Water↗
The 'anatomy' of infant sucking.
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Adult↗
An ultrasonographic study of the organisation of sucking and swallowing by newborn infants.
Healthy infants' sucking, swallowing and breathing movements were observed ultrasonographically during breast- and bottle-feeding between two and five days after birth. Sucks were found to occur either on their own or in combination with a swallow. Swallows did not occur on their own. Younger babies' swallowing invariably was associated with a pause in breathing. Older babies generally showed better co-ordination of sucking, swallowing and breathing than younger ones, whether breast- or bottle-feeding.
Bottle Feeding↗
The initiation of lactation: the effect of early versus delayed contact for suckling on milk intake in the first week post-partum. A study in Chiang Mai, Northern Thailand.
The effect of reducing the length of routine mother/infant separation following delivery on milk intake in the first week of life was examined prospectively in 22 term infants in Chiang Mai, Northern Thailand. Infants were randomly assigned to two groups: a late contact group (control) who followed routine hospital policy (mean separation between mother and baby 25.1 h), and an early contact group (experimental) in which mother and baby were re-united as soon as possible following standard clinical observations (mean separation after delivery of 3.6 h). Despite a difference of 22.4 in the mean age at which babies in the two groups were first suckled, no experimental difference was found in milk volume transfer over post-partum days 2-5 determined by test weighing at a morning feed with an integrating electronic balance. An observational study was performed concurrently, which showed that early contact group mothers were likely to have given 8 additional breast feeds during the extra 21.5 h they had with their infant.
Adult↗
Evaluating breast-milk intake by test weighing: a portable electronic balance suitable for community and field studies.
A K-Tron Digital Scale (Model DS-1) was used to weigh a group of 52 new born babies. The regression of the weights on true weights obtained with a Sartorius electronic balance 3806MP was 0.9911, with an estimated residual variance of 5.25. With the same babies weighed on a Marsden Weighmaster, the estimated residual variance was 68.93. Data from published studies on other balances are presented for comparison. The K-Tron is a reliable, portable, battery operated balance suitable for measuring milk intake by test weighing in homes or in the field.
Biometry↗
Individual patterns of milk intake during breast-feeding.
The pattern of milk transfer during breast-feeding was ascertained for individual mother-infant pairs using a 'fractional' weighing technique. This method employs a single, fixed intermediate weighing on each breast, and a flexible, final weighing point at the 'natural' termination of feeding on each breast. The data demonstrate considerable variability between individuals both in feed length and in the rate of milk transfer from mother to baby. They show that the rate of intake tends to be consistent between the first and second breast, and that each mother-infant pair has a characteristic rate of milk transfer. Significant milk intake occurred from four minutes to the end of the feed on each breast. These results imply that breast-feeding 'rules' about the length of a feed can only be offered as helpful guidelines, rather than principles to be strictly followed. The results of a reciprocal nursing experiment suggest that the typical rate of milk transfer is a product of both milk release by the mother and milk demand by the baby.
Body Weight↗
The continuous measurement of milk intake at a feed in breast-fed babies.
A method for the continuous measurement of milk intake during a breast-feed is described. A miniature Doppler ultrasound flow transducer, located in the tip of a latex nipple shield, is interposed between mother and baby during feeding. Preliminary results indicate the scope and current limitations of the method in terms of both populations and individual mother/infant pairs. An initial analysis of individual feeds indicates that two factors may contribute to the curtailment of intake during a feed from one breast: a progressive reduction in intake volume per suck, and/or an increase in the proportion of time spent pausing between bursts of sucking.
Breast Feeding↗
Does a change in the composition of human milk affect sucking patterns and milk intake?
Human breast milk of high and low fat content was fed to twenty-four babies aged 4-9 days from bottles. Changes in fat content parallel to those found during the course of a breast-feed (i.e., switching the baby from low-fat breast milk to high-fat breast milk) did not alter either milk intake rate or sucking patterns.
Bottle Feeding↗
Effect of a traditional and of a new nipple shield on sucking patterns and milk flow.
The effect of a traditional (Mexican Hat) and of a new (Thin Latex) nipple shield on the sucking patterns and milk intake of 5-8-day-old babies was examined. Milk intake was determined accurately by test weighing using a Sartorius electronic balance with animal weighing keyboard, and sucking patterns by filming the mouth of the baby. The Mexican Hat reduced milk transfer by 58% (P is less than 0.01), and increased sucking rate (P is less than 0.05) and time spent resting (P is less than 0.01). The Thin Latex nipple shield reduced milk intake by a smaller amount (22%), and had no significant effect on sucking patterns.
Breast Feeding↗
Indirect test weighing: a new method for measuring overnight breast milk intakes in the field.
Indirect test weighing (ITW), a new method for measuring nighttime breast milk intake, is based on separate weighings of the mother and infant at the start and end of the nighttime sleep period. All other incidental weight changes overnight are measured, so that the corrected infant's overnight weight gain and the mother's overnight weight loss are then accounted for by breast milk transfer and evaporative water loss (EWL) alone. The combined EWL is partitioned between mother and infant on the basis of metabolic body size (body weight raised to the power of 0.73). The infant's EWL is added onto the corrected overnight weight gain to give nighttime milk intake. A field validation study on 24 northern Thai infants, conducted in the subject's homes, in which ITW was compared with nighttime direct test weighing (DTW) on the same night, gives 95% confidence intervals for the method of +/- 39 g for a range of milk intakes of 77-344 g. Confidence intervals for estimates using feeding patterns alone, or multiplying 12 h intakes by a constant, range from +/- 104 to 180 g, indicating that these methods are insufficiently accurate for individual estimates.
Body Weight↗