The ‘anatomy’ of infant sucking

Manejo clínico das disfunções orais na amamentação

“…These jaw movements provide important stimuli to the growth of the temporomandibular joint and, consequently, to the harmonic growth of the baby s face. 8,[14][15][16][17] During breastfeeding, the tongue elevates its borders laterally (transversal and vertical muscles), along with its tip, forming a trough, which collects the milk to be swallowed in the oropharynx. [14][15][16] When the milk collects on the tongue, in the posterior region of the mouth, a rhythmic peristaltic movement is started, going from the tip of the tongue to the oropharynx, gently compressing the whole nipple, thus finishing milk removal and starting the swallowing process.…”

“…This way, the milk is extracted smoothly, without any pressure, which could cause friction and nipple injury. [14][15][16][17] …”

Biomechanics of milk extraction during breast-feeding

“…First, the infant latches onto the breast and nipple so that the nipple, areola, and underlying mammary tissue and lactiferous ducts are drawn into the infant's mouth with the nipple tip extended as far as the hard-soft palate junction (HSPJ). Then, the infant moves its mandible up and down, compressing the areola and the underlying lactiferous ducts with its gums in a suckling process that extracts the milk into its mouth (3,4). Simultaneous with compression, spontaneous undulating motions of the infant tongue channel the milk posteriorly and trigger the swallowing reflex (5).…”

“…The two proposed mechanisms that have been a subject of scientific controversy to this day are (i) sucking-emptying of the nipple-breast contents by development of subatmospheric pressures within the infant oral cavity (9)(10)(11)(12) and (ii) mouthingsqueezing out of the nipple-areola contents by compression between the jaws or other mouth parts (3). With the appearance of cine-X-ray and ultrasound (US) imaging modalities, a significant role was also attributed to tongue undulation which was naturally referred to as "tongue peristalsis" while chewing the nipple (13,14).…”

Breastmilk: It's Not Just for Breakfast Anymore!

“…As the oro-motor skills used to suckle at breast and suck at a bottle differ, 8 and the introduction of a bottle is associated with shorter durations of breastfeeding, 9 there is concern that preterm infants may have difficulty breastfeeding if bottles are used. In most of the world, cups are used as the primary method of supplementing term and preterm infants, but US neonatologists gasp in horror, fearing ''aspiration.''…”