Glenn Evans wrote:

Hello again,

Houston we have a problem!  For some reason my mailer still picks up
your posts in word wrap and when I try to respond half you message ends
up somewhere east of the Hale-Bopp.  Is there any way you can put your
posts in standard format.  I was nailed for doing it (unbeknownst to
me)in another group but to the life of me I don't know how it was
corrected.  Enough of that.

> Geoff -- Actually, I'm from Wisconsin, and visit occasionally.  I grew up in Milwaukee, and graduated from UW-Madison.

Where in Milwaukee?  `Tis my hometown.

> You still have not answered my questions re:
>
> What were the populations studied?  When I supposed they were predominantly bottle-feeding populations, you claimed the research said
otherwise.  Again, I ask< (Post ended here)

My inference was neither for cup drinking, BF or bottle feeding.  My
point was that when you feed an infant in a mode that their motor skills
are not built to accomodate (Morris, Evans, Cupps, Alexander, et. al),
the risk of aspiration cannot be discounted.  I have not seen any other
evidence to dispute this development, only anecdotal evidence "that it
works".  That is in no way a contradiction of anecdote, but one of
concern for the potential risks.  And again, milk is not "lapped".
Lapping is a mechanical sort of shoveling fluid rearward.  Infants
suckle.  Liquid moves because of negative air pressure drawing the
liquid rearward when no air pockets (in the bolus) are present, such as
a piston draws air and gas for combustion.  An infant's swallow can
be directly seen only by fluoroscopy or ultrasound.  Seeing the external
movements and liquid disappear is not seeing the swallow.  You cannot
tell what happens in the pharynx unless you see it.  I know what tools
are used to judge if the swallow was safe but each one is questionable
with regard to accuracy.  Can you explain what happens in the pharynx
when swallow occurs.  How can you tell if the mechanism is "safe" with
regard to aspiration.  What happens with breast or nipple is liquid is
expressed into the pharynx by negative pressure created in the pharynx
and positve pressure on the nipple.  This pressure creates cohesion of
the bolus.  The pharynx is filled, breathing is interrupted, the
suprahyoid contracts lifting the larynx, the vocal cords close and the
epiglottis moves posteriorly to cover the laryngeal and airway opening.
 The elevation of the larynx opens the cricopharyngeal muscles that
separates the pharynx and esophagus and prevents reflux.  The pharynx
contracts to push the bolus posteriorly, all muscles relax and
Cricopharyngeus contracts to cose off the esophagus from the pharynx.
This all happens effectively when variable is present - the bolus
maintains it's cohesiveness.  This was proven ad infinitum.  But, when
fluid is drawn through the oral cavity it remains cohesive only as long
as negative pressure is available.  Like siphoning water through a hose.
 But what happens when you pull the other end from the water source?
The flow (cohesion) is lost.  That is what happens when the infant
tongue moves forward to create a new cycle of suction such as a piston.
 the pharyngeal cavity is opened thus diminishing the negative pressure
created by the previous cycle.  Fluid is in free fall.  Again documented
in 6 mo. old kids learning cup drinking under fluoroscopy.  The
difference is that 6 mo. old kids have extensor lingual tone to undulate
the tongue to protect and propel the bo;us and maintain that negative
pressure.  What happens when that negative pressure is released and the
fluid is in free fall?  That is not documented fully and needs to be.
And that folks is my point.

> I am not saying that if a child has CP or severe asthma, you throw out the results.  I am asking, however, if autopsies on other children,
without these proble< (This is all I received.)

> It is not a non-sequiter (sp) to question the variables.  My understanding is cystic fibrosis is present before the baby's first
swallows.  And asthma has many
>
> You have not answered my questions about colonization.  Others are adamant that EBM does not colonize -- I don't know if I believe that
either.  But my questio<  (Opps again!)

Re: colonization, I have no clue.  But EBM is rather rich in content and
I can only surmise the outcome, right or wrong.  And as far as the
antibodies, well I know of no other intentionally invasive lung
treatment and i'm sure there is a reason for it.

> You ask if I'm suggesting foreign germs or GERD?  If it is stuff aspirated while going down, couldn't it only be from the milk or the
outside?  And if it is GE< (I hate to say it but...)

> Finally, my point about the kayaking was this.  The un-steered jars are the same as my unsteered rubber kayak.  They will follow the higher
pressure water wher
> probabilities exist only when:  They are put into the water equidistant
> between the two banks, the water pressure is exactly equal from both
> sides, and the river forks are also exactly equal in water pressure.

If the airway is open under the circumstances described by me above, the
air pressure varibles should be equal the law of physics and probabilty
say 50/50.  If the vocal cords open precisely as the liquid reaches that
level and the cricopharyngeus remains closed physics are not in the
infants favor.  Thus is aspiration.

> Please post your replies to Lactnet as well, as many people are voicing interest in our volley.<

Yep!

> Sincerely, Chanita
>
> Oh please note, I have corrected your name in the subject heading.  Also,
> I am Chanita, not Glenn.  Glenn is my husband, and the owner of this site, but is a computer consultant not a lactation consultant.

Sorry, my computer tosses back what is read.  I'll correct it.

Geoff