Most babies are born with an innate ability to suck. Sucking not only is a means to nourishment but also a source of comfort. Even so, there are some newborns that encounter issues with sucking and swallowing. If you are concerned with your infant's ability to suck and swallow, contact your health care provider, lactation consultant or local La Leche League.
Significance
According to Judith Lauwers and Anna Swisher, co-authors of Counseling the Nursing Mother, sucking provides comfort and nourishment for babies. Sucking produces saliva, which helps to break down food before it reaches the stomach, helps digestion and movement of food through the gut. Hormones called cholecystokinin or CCK are released in the gut during sucking, which promotes a calming effect. Sucking also triggers breast milk production and let down in lactating mothers as well as oxytocin, which calms the mother. Sucking in a breastfed infant is the act of drawing breast tissue into the mouth using negative pressure to keep the breast in the mouth. Suckling is the act of removing the milk from the breast with the child's tongue.
Sucking Needs
Amazingly, newborns are not born hungry. Hunger is a learned trait. Even so, sucking needs vary from infant to infant. Lauwers and Swisher state that some infants are born with sucking marks on their hands and sucking needs are usually highest during the first three months of life. Non-nutritive sucking with pacifiers is often used with preterm infants to support sucking, breathing and swallowing coordination. Pinelli and Symington conducted a review of studies done on non-nutritive sucking and found that infants that were allowed to suck for the purpose of sucking were released from the hospital sooner, fell asleep easier and were generally calmer.
Sucking Pattern
Lauwers and Swisher explain that a breastfeeding baby sucks in a pattern that inversely corresponds to the amount of milk he is receiving. For example, slower sucking is associated with high rates of milk flow. A study done in 2002 showed that infant suck rates range from 55 sucks per minute after birth to 70 sucks per minute by the first month. The rate of swallowing increases from 46 swallows a minute to 50 swallows a minute.
Preterm Infants
According to MedlinePlus, an online service provided by the National Institutes of Health and the U.S. National Library of Medicine, an infant born prior to 34 weeks is usually unable to coordinate sucking, breathing and swallowing. In this case, a small feeding tube is placed through the mouth or nose into the stomach, known as gavage feeding. Sometimes it is necessary to feed a preterm infant intravenously until she is stable. If a premature baby seems ready, she can be offered the breast, bottle or breast milk from a bottle when milk flow is an issue. Lauwers and Swisher state that preterm infants take a breast easier than a bottle in some cases; the skin to skin contact helps the infant maintain body temperature and alertness while feeding. Consult a lactation consultant before introducing a bottle or if there are questions about pumping breast milk or breastfeeding.
Considerations
The use of a pacifier or other sucking apparatus may help support the relationship between sucking and swallowing, mostly in preterm infants. Even so, introducing these items may cause nipple confusion. Nipple confusion can make it more difficult to breastfeed. This is because sucking at the breast is different from sucking on a bottle. In a breastfed infant the tongue helps to create negative pressure by pushing down over the lower gum, while in a bottle fed infant the tongue moves up toward the bottle nipple to control the milk flow. Tongue thrusting is one of the long-term affects of overuse of artificial nipples that can extend into adulthood. Special attention to breastfeeding latch should be taken and you should seek the assistance of a lactation consultant. Lauwers and Swisher, in "Counseling the Nursing Mother," also discuss the use of drugs during labor adversely affecting the newborn's ability for nutritive sucking. There are also oral deformities that may impare the sucking and swallowing ability; these can sometimes be fixed by small surgical procedures or special attention from a lactation consultant.
References
- The Cochrane Collaboration: Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants
- "Counseling the Nursing Mother"; J. Lauwers, A. Swisher; 2005
- MedlinePlus: Neonatal weight gain and nutrition
- MedlinePlus: Premature infant
