Oxygen Saturation and Suck-Swallow-Breathe Coordination of Term Infants during Breastfeeding and Feeding from a Teat Releasing Milk Only with Vacuum

Abstract

Background. Vacuum is an important factor in milk removal from the breast, yet compression is the predominant component of milk removal from bottle teats. Since bottle-feeding infants have lower oxygen saturation, vacuum levels, and different suck-swallow-breathe (SSwB) coordination to breastfeeding infants, we hypothesised that when infants fed from a teat that required a vacuum threshold of −29 mmHg for milk removal, that oxygen saturation, heart rate, and suck-swallow-breathe (SSwB) patterns would be similar to those of breastfeeding. Study Design. Infants (n = 16) were monitored during one breastfeed and one feed from the experimental teat. Simultaneous recordings were made of oxygen saturation, heart rate, vacuum, tongue movement, respiration, and swallowing. Results. There were no differences in oxygen saturation and heart rate between the breast and the teat. Infants displayed fewer sucks and breaths per swallow during nutritive sucking (NS) compared to non-nutritive sucking (NNS). The number of sucks per breath was similar for NS and NNS although respiratory rates were slower during NS. These patterns did not differ between the breast and the teat. Conclusion. These results suggest that vacuum may be conducive to safe and coordinated milk removal by the infant during both breast and bottle-feeding.

Longitudinal Changes in Suck-Swallow-Breathe, Oxygen Saturation, and Heart Rate Patterns in Term Breastfeeding Infants

“…20 Sucks and pauses were classified as NS if milk flow was observed in the intra-oral cavity; nutritive pausing (NP) if the pause occurred directly after NS; NNS if no milk flow was observed in the intra-oral cavity on ultrasound; and non-nutritive pausing (NNP) for subsequent pauses ( Figure 1). 17 For each suck burst, burst type (NS/NNS), peak vacuum (mean minimum pressure, mmHg), baseline vacuum (mean maximum pressure, mmHg), suck rate (sucks/min), respiratory rate (breaths/min), suck burst duration (s), total burst duration (s), heart rate (beats per min), and oxygen saturation (%) were calculated. For each pause, pause type (NP/NNP), mean vacuum, respiratory rate, pause duration, total pause duration, heart rate, and oxygen saturation were calculated.…”

“…Oxygen saturation (Sp0 2 ) and heart rate were recorded using pulse oximetry 16 (Radical/MasimoSET V4.1) with a pediatric sensor (LNOP YI Multisite) taped to the distal end of the infant's foot. 17 At each assessment, milk intake was determined by weighing the infant before and after breastfeeding using an electronic baby weigh scale (Medela AG, Baar, Switzerland, resolution 2 g, accuracy ± 0.034%). Milk intake (g) was calculated by subtracting the initial weight from the final weight.…”

Bottle‐feeding an infant feeding modality: An integrative literature review

“…Several studies debated the primacy of suction and or compression in milk transfer when feeding; with suction being the main element proposed for how breastfeeding infants obtain milk and compression as the main element for bottle‐feeding infants (Geddes et al, ; Sakalidis et al, ; Weber et al, ). Both Geddes et al () and Sakalidis et al () used an experimental teat that only released milk by suction, which demonstrated that suction was responsible for milk transfer, not compression. The infants who participated in both studies were breastfeeding and had previously supplemented their feeds with a bottle.…”

“…Therefore, the change in SSB pattern differs depending upon which part of the feed is observed (Taki et al, ). Overall, there seem to be minimal differences in oxygen saturation and SSB patterns between healthy term breast‐ and bottle‐feeding infants (Fadavi et al, ; Goldfield et al, ; Sakalidis et al, ; Weber et al, ). The studies determined that feeding modality does not necessarily influence SSB patterns.…”

“…Only three studies provided information on the teat material used: latex/rubber and silicone (Moral et al, ; Walden & Prendergast, ; Weber et al, ). The teat flow rate was described in studies as like breastfeeding, medium flow, or the same flow (Fadavi et al, ; Moral et al, ; Sakalidis et al, ). Teats were named either by brand or shape, with little or no detail given on their characteristics (Fadavi et al, ; Mathew, ; Moral et al, ; Nowak et al, ; Taki et al, ).…”