always keep reading and learn new things. just because you read it in the
newspapers don't make it so, i have heard. so listen up:

"Feeding and Swallowing Disorders in Infancy: Assessment and Management" Wolf
and Glass.

p. 46  "Thus, all infants, term and preterm, are able to breathe through their
mouths to some degree when faced with nasal occlusion. To do so, however,
requires the infant to carry out a series of complex motions. The baby must
open the lips and generate sufficient muscle tone to overcome the adhesive
forces between the palate and tongue, and maintain separation of these
structures to allow airflow through the mouth. Although infants can
spontaneously breathe through the mouth, frequently it is done at a cost to
the infant in terms of efficiency of breathing. Although this cost is more
significant in preterm than in term infants, neither group may be able to
effectively sustain oral breathing and may therefore develop progressive
respiratory failure. (my note: suctioning won't fix this type of thing) So,
while infants are not obligatory nose breathers and can switch to oral
breathing for short periods of time, nasal breathing is clearly preferred from
a respiratory standpoint. It is still unclear at what age, if ever, a baby
could sustain itself on oral breathing alone, without respiratory compromise."
(my note: it has to happen at some age, since we see children who breathe
through their mouths for various reasons, perhaps among them children whose
facial structure is misshapen due to lack of breastfeeding perhaps due to oral
aversions caused by invasive hospital techniques, still with me here?)

References:
Miller, J.M., R. J. Martin, W. A. Carlo, J. M. Fouke, K. P. Strohl, and A. A.
Fanaroff. 1985. Oral breathing in newborn infants. The journal of pediatrics
107:465-69.

Miller, M. J., W. A. Carlo, K. P. Strohl, A. A. Fanaroff, and R. J. Martin
1986. effect of maturation on oral breathing in sleeping premature infants.
The Journal of Pediatrics 109:515-19.

Wilson, S. L., B. T. Thach, R. T. Brouilette, and Y. K. Abu-Osba. 1980 Upper
airway patency in the human infant: Influence of airway pressure and posture.
Journal of Applied Physiology 48:500-504.

Miller, M. J., R. J. Martin, W. A. Carlo, and A. A. Fanaroff. 1987. Oral
breathing in response to nasal trauma in term infants. The Journal of
Pediatrics 79:899-901.

i haven't read these actual studies, although i would like to. however, i
point this little citation out to show that, just because it is a standard
remark in "most" of the standard texts, doesn't make it unquestionable. and
the reason i was interested in looking for further information on this
question is that, based on my own observations, i felt it could not be
entirely true that infants could "never" breathe through their mouths.

why not? well, if adults can do it, and two year olds can do it, then why
can't babies do it? if they absolutely could not, then there would be some
magic day on which the ability to mouth breathe suddenly appeared. some sort
of physical change that happened and was observable. and probably some magic
mechanism would be involved that would prevent babies from getting any kind of
nasal congestion until that magic day came along, because it would so often be
fatal.

the wolf and glass book is written for occupational therapists, and it's true
they don't say much about breastfeeding, a complaint i made to the person who
recommended i read the book. but it is still valuable. but use some common
sense and professional observations, as well.

those who work in hospital settings often do not see the fallout of what we in
lactation regard as invasive and unnecessary techniques, and thus do not see
the necessity of making changes.

carol brussel IBCLC