[Sucking Boobs During Sex
Saija Grzegorek
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This prospective study compared the coordination of sucking, swallowing, and breathing and its relationship to oxygen saturation in infants during breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, infants began bottle-feedings of expressed human milk using one of two systems: a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and oxygenation were measured during breast-feeding and bottle-feeding, and coordination of these activities during breast-feeding and bottle-feeding were compared. During breast-feeding, swallowing occurred nonrandomly between breaths and did not interfere with breathing. The same distribution of swallowing occurred in infants fed with system 1, while swallowing occurred randomly in infants fed with system 2. Swallowing significantly increased during bottle-feeding among infants using system 2, but decreased among infants using system 1. Infants using system 2 also had a greater instability in the coordination of sucking, swallowing, and breathing and more perturbation of breathing. Oxygen saturation was significantly higher in infants fed with system 1 compared with system 2. These results suggest that the overall feeding pattern and oxygenation of system 1 are closer to the physiologic norm than system 2.
Our aim was to obtain a better understanding of the differences between breast-feeding and bottle-feeding, particularly with regard to how sucking performance changes from nonnutritive sucking (NNS) to nutritive sucking (NS). Twenty-two normal term infants were studied while breast-feeding at 4 and 5 d postpartum. Five of the 22 infants were exclusively breast-fed, but we tested the other 17 infants while breast-feeding and while bottle-feeding. Before the milk ejection reflex (MER) occurs, little milk is available. As such, infants perform NNS before MER. For bottle-feeding, a one-way valve was affixed between the teat and the bottle so that the infants needed to perform NNS until milk flowed into the teat chamber. At the breast, the sucking pressure (-93.1 +/- 28.3 mm Hg) was higher during NNS compared with NS (-77.3 +/- 27.0 mm Hg). With a bottle, the sucking pressure was lower during NNS (-27.5 +/- 11.2 mm Hg) compared with NS (-87.5 +/- 28.5 mm Hg). Sucking frequency was higher and sucking duration was shorter during NNS compared with that during NS both at the breast and with a bottle. There were significant differences in the changes of sucking pressure and duration from NNS to NS between breast- and bottle-feeding. The change in sucking pressure and duration from NNS to NS differed between breast-feeding and bottle-feeding. Even with a modified bottle and teats, bottle-feeding differs from breast-feeding.
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The objective of our study was to compare the coordination of sucking, swallowing, and breathing during breast-feeding and bottle-feeding. We also examined the relationship between oxygen saturation and coordination. To allow a detailed analysis of these events, we recorded sucks, swallows, respiratory airflow, and respiratory movements and analyzed the location of swallows to compare coordination. We studied 1) the distribution of swallows relative to sucking and breathing, 2) the amount of swallowing, 3) the stability of swallowing, 4) oxygen saturation, and 5) the correlation between oxygen saturation and swallowing variability. Our hypotheses were that during breast-feeding, swallows would be distributed nonrandomly (i.e. at specific locations) and that a bottle-feeding system that more closely mimics the physiologic norm would promote a similar swallowing pattern. We also hypothesized that during periods of higher oxygenation, the coordination of sucking, swallowing, and breathing would be more stable (have lower variability) and that during periods of lower oxygenation, the variability of swallowing relative to breathing would be greater.
Mothers and infants were recruited in hospital on the second day after birth by research nurses at Beth Israel Deaconess Medical Center in Boston, MA. Each day during the recruitment period, one of two research-study nurses reviewed data from the birth census to determine eligibility of potential participants. Eligibility criteria included infant birth weight greater than 2500 g, no medical problems that might influence feeding, and no maternal complications during pregnancy or delivery. All infants who met these criteria were eligible for the study regardless of gender or ethnicity. A second set of eligibility criteria concerned the mother's plans for feeding the infant. Only those women who indicated to the research nurse that they planned to breast-feed the infant exclusively for at least 4 to 6 wk after birth before initiating bottle-feeding (while continuing to breast-feed) were eligible. Mothers were excluded if their medical charts indicated any structural or functional characteristics that might impede breast-feeding. The study was described, and mothers were told that study participation involved a laboratory visit at Children's Hospital Boston after 4 wk of exclusive breast-feeding. Women who met these criteria and agreed to participate provided written informed consent. Mothers agreed to be contacted by telephone approximately 4 wk after leaving the hospital to arrange a time for the laboratory visit. If a mother decided to discontinue participation at any time before the laboratory visit, she and the baby were replaced in the study.
The research protocol was approved by the clinical investigation committees at Beth Israel Deaconess Medical Center and Children's Hospital Boston. Infants served as their own controls for comparison of breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, mothers introduced an artificial nipple and bottle for supplemental feeding. All bottle-feeding was performed with expressed breast milk. For supplementation, mothers chose either system 1 (a Playtex bottle with a soft-liner that collapses during feeding and a NaturaLatch nipple; Playtex Products, Inc., Westport, CT) or system 2 (an Avent newborn bottle and nipple; Avent Ltd., Bensenville, IL); both bottle systems are commercially available and had equivalent flow rates. Within 2 wk of initiating supplemental bottle-feeding, mothers and infants came to the Infancy Laboratory in the Department of Psychiatry at Children's Hospital Boston for the laboratory visit, which consisted of a 30-min procedure during which instrumented recording of 3 to 4 min of sucking, swallowing, breathing, and oxygen saturation during breast-feeding and bottle-feeding, respectively, were performed; the infant was weighed; and the mother completed a brief oral interview to determine her attitudes about breast-feeding.
For instrumented recordings of the infant's sucking, swallowing, and breathing during breast-feeding and bottle-feeding, sensors were attached to the skin of both the mother's breast and the infant. The goal was to use the same sensors for breast-feeding and bottle-feeding to get equivalent information. To record the intraoral sucking pressure during breast-feeding, a catheter was secured using medical-grade tape (Transpore Surgical Tape; 3M, St. Paul, MN) so that its open end was aligned with the tip of the mother's nipple and was taken into the infant's mouth during feeding. To record intraoral pressure during bottle-feeding, the infant was fed with a nipple that was modified slightly from the ones used at home. A catheter identical to the one previously attached to the mother's breast was embedded within the bottle nipple so that it entered the infant's mouth during feeding. To record swallowing, a miniature wireless microphone (SC4-CT; Shure, Inc., Niles, IL) was secured with tape to the skin beneath the cricoid and oriented toward the pharynx (14). To record respiratory movements, inductance bands (Inductotrace respiratory monitors; Ambulatory Monitoring, Inc., Ardsley, NY) were secured around the infant's chest and abdomen, and an oxygen saturation sensor was also secured on one foot; the signal from the latter was analyzed by a pulse oximeter (Radical; Masimo Corporation, Irvine, CA). All sensor signals were digitized and simultaneously recorded with data-acquisition software (WinDaq/Pro+; Dataq Instruments, Inc., Akron, OH) on a laptop computer (Dell Latitude CPi; Dell, Inc., Round Rock, TX). Infants were also weighed after feeding using a pediatric scale (Model 4802; Scaletronix, Carol Stream, IL).
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