> Catherine's post about bottle nipples points to the fact that  we need to
> learn about what is available and how differennt bottles/nipples  work.>>

In view of this you might be interested in some research being done on
infant suck mechanics and an experimental teat that was (also) presented at
ISRHML 2004 conducted by Donna Ramsey and the Hartmann group.
A brief synopsis as follows:

 (Ultrasound imaging of the sucking mechanics of the breastfeeding infant
 DT RAMSAY, LR MITOULAS, JC KENT, PE HARTMANN).
"Sub-mental ultrasound  scans of the interior of the mouth of eight fully
breastfed infants (1-16 weeks) were performed during a breastfeed.
Intra-oral pressures were measured simultaneously via a milk­filled supply
line (SNS) connected to a pressure transducer.
Negative pressure generated by the infant as the tongue moved down resulted
in opening of milk ducts in the nipple and milk flow from the breast.
Therefore, we conclude it is the negative pressure exerted by the infant
during sucking that plays a major role in milk removal from the breast
rather than a stripping action by the tongue"

This finding will I'm sure cause a great deal of discussion as it challenges
firmly held beliefs we have had for many years now. But it is great to see
hard research emerging in this area that will assist us to eventually better
support babies with suck difficulties.

(Ultrasound imaging of the sucking mechanics of infant feeding from the
breast and an experimental teat
 DT RAMSAY, LR MITOULAS, JC KENT, B SILVER, PE HARTMANN).
"Sub-mental ultrasound  scans of the interior of the mouth of seven fully
breastfed infants (1-16 weeks) were performed during a breastfeed and during
a feed of expressed breast milk using an experimental teat (solid silicone
containing four milk channels). Intra-oral pressures were measured
simultaneously via a milk­filled supply line (SNS) connected to a pressure
transducer.
Milk flow from both the breast and the experimental teat was associated with
peak negative pressure during infant sucking. Infants used a similar sucking
mechanism to remove breast milk from the experimental teat as the breast".

This obviously refers to only the experimental teat used and shouldn't be
assumed to apply across a range of variable teats (although it might)


The full abstracts from these poster presentations can be obtained from the
proceedings for the conference but papers will follow next year.

Donna has also done some very nice research on Frenulotomy, which she also
presented at ISRHML,
(Ultrasound Imaging of the effect of Frenulotomy on breastfeeding infants
with Ankyloglossia
DT Ramsay, DB Langton, I Gollow, K Simmer)

using ultrasound imaging (before and after frenulotomy) she showed very
positive results on suck mechanics and a significantly increased milk volume
removal by the infant following frenulotomy.

Regards
Cathy Fetherston RM PhD IBCLC
Perth, Western Australia

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