Catherine F. wrote:
'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.'
Well if nothing else, LCs have to be ready to have their knowledge
challenged and updated all the time. Remember "blowing-drying a sore nipple"?
Very interesting findings, and now I wonder how much the ability of the
back of the tongue to drop strongly and create negative pressure is related
to the stability and range of the front of the tongue to maintain itself up
and in contact with the mom's breast tissue. I guess I am just thinking out
loud and looking at how many things need to go "right", to be strong, stable and
flexible, proactive, responsive, for efficient feeding to happen. Add in
the individual mom's nipple length, thickness, elasticity, speed and power of
MER, etc, and the variants are nearly unlimited. It seems I have been seeing
babies who will react to flow, but don't trigger it, their tongues are flat,
short, bound, somehow limited in either range or power or both, etc.
Sometimes clipping helps ( tight, anterior attachments) , other times only time and
maintaining mom's supply...
Judy LeVan Fram, PT, IBCLC
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