A Review of Quantitative Instruments for Understanding Breastfeeding Dynamics

Abstract

More than two decades ago, breastfeeding was recognized as the most effective international preventive health intervention, with the potential to prevent 13% of deaths among children younger than 5 years of age worldwide. [3] Studies have shown that infants who do not receive human milk are at higher risk for a number of medical issues, including necrotizing enterocolitis, [4,5] gastrointestinal and upper respiratory tract illness, [6,7] and urinary tract infections. [8] The World Health Organization suggests that all newborns should consume solely human milk during the first six months of life and continue with proper complementary foods until 2 years of age. [9] Breastfeeding has also been recognized as the ideal source of nourishment and the preferred primary feeding modality for infants by the American Association of Pediatrics. In addition, the US Surgeon General published a "Breastfeeding Call to Action" in 2011, touting the benefits of breastfeeding and encouraging all US families to pursue breastfeeding. [10] This renewed interest in breastfeeding fueled ongoing clinical and industrial investigations addressing different aspects of breastfeeding, including nutrition quality, breastfeeding duration, positioning, sucking and swallowing frequency, and latching effectiveness. [11,12] Throughout this review, we use the term "sucking," which refers to a complex interaction and coordination of an infant's jaw, hyoid bone, palate, pharynx, and tongue to coordinate milk removal during breastfeeding. [13,14] Additionally, the term "sucking microstructure" will be noted in different Breastfeeding, as a unique behavior of the postpartum period and an ideal source of nourishment, is profoundly impacted by the physiology and behavior of both mothers and infants. For more than three-quarters of a century, there has been an ongoing advancement of instruments that permit insight into the complex process of latching during breastfeeding, which includes coordinating sucking, swallowing, and breathing. Despite the available methodologies for understanding latching dynamics, there continues to be a large void in the understanding of infant latching and feeding. The causes for many breastfeeding difficulties remain unclear, and until a clearer understanding of the mechanics involved is achieved, the struggle will continue in the attempts to aid infants and mothers who struggle to breastfeed. In this review, the history of development for the most prominent tools employed to analyze breastfeeding dynamics is presented. Additionally, the importance of the most advanced instruments and systems used to understand latching dynamics is highlighted and how medical practitioners utilize them is reported. Finally, a controversial argument amongst pediatric otolaryngolo gists concerning breastfeeding difficulties is reviewed and the urgent need for quantification of latching dynamics in conjunction with milk removal rate through prospective controlled studies is discussed.

Application of Statistical Analysis and Machine Learning to Identify Infants’ Abnormal Suckling Behavior

“…In this paper, we focus on suckling vacuum as a starting point as prior research has shown that infant's intraoral vacuum is essential to effective milk extraction [28]. An analysis of NNS vacuum signals can provide infant oral measurement information such as mean oral vacuum, suckling frequency, burst duration, sucks per burst, maximum vacuum, and signal shape, details important in understanding infant suckling behavior [29,23]. These measurements provide key information on an infant's suckling ability and can be used to determine infant suckling irregularities.…”