Research presented at the Medela breastfeeding and lactating symposium in Venice, Italy, suggests that I may have got it all wrong. Although it might look like a baby is chewing on the mother's nipple, ultrasound images show that the infant actually removes milk by creating a vacuum also known as sucking. The finding is important, as it could explain why some babies fail to take to the breast. It may also shed new light on why for a minority of women breastfeeding really can be a painful experience. Squeeze or suck? "There have been two theories about how breast milk is expressed," says Donna Geddes (no relation) of the University of Western Australia in Crawley. "One is that the baby uses a peristaltic or compression motion to actually push the milk out of the nipple and breast. The other theory is that vacuum is primary in removing the milk." Until now, most studies examining the mechanics of breastfeeding have focused on bottle-feeding infants, or on old X-rays that were of poor quality. Instead, Geddes and her colleagues combined ultrasound imaging of infants suckling on the breast with measurements of the strength of the vacuum created by the baby's mouth in 20 infants aged 3 to 24 weeks as they breastfed (see video). "What we see is that when the tongue is lowered and the vacuum is applied, that's when the milk is coming out of the breast, and that doesn't involve any compression of the nipple," says Geddes. "It's not a milking action at all." Feeding failures They ...
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