School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia.
J Hum Lact. 2013 May;29(2):236-45. doi: 10.1177/0890334412474864. Epub 2013 Mar 14.
Despite the differences in breastfeeding and bottle-feeding, our understanding of how suck-swallow-breathe (SSwB), oxygenation, and heart rate patterns change as the infant ages is based predominantly on bottle-feeding studies. Therefore, this study aimed to measure how SSwB, oxygenation, and heart rate patterns changed during the first 4 months of lactation in term breastfeeding infants.
Infants less than 1 month postpartum (n = 15) were monitored early in lactation and again later in lactation (2-4 months postpartum). Simultaneous recordings of vacuum, tongue movement, respiration, swallowing, oxygen saturation, and heart rate were made during both nutritive sucking and non-nutritive sucking during breastfeeding.
Infants transferred a similar amount of milk (P = .15) over a shorter duration later in lactation (P = .04). Compared to early lactation, suck bursts became longer (P < .001), pauses became shorter (P < .001), vacuum levels decreased (all P < .05), oxygen saturation increased (P < .001), and heart rate decreased (P < .001) later in lactation.
This study confirmed that term infants become more efficient at breastfeeding as they age, primarily by extending their suck bursts and pausing less. Although infants demonstrated satisfactory SSwB coordination during early lactation, they showed a level of adaption or conditioning at later lactation by applying weaker vacuum levels and demonstrating improved cardiorespiratory responses.
尽管母乳喂养和奶瓶喂养存在差异,但我们对婴儿吮吸-吞咽-呼吸(SSwB)、氧合和心率模式如何随年龄变化的理解主要基于奶瓶喂养研究。因此,本研究旨在测量母乳喂养的足月婴儿在哺乳期的前 4 个月中 SSwB、氧合和心率模式如何变化。
产后不到 1 个月的婴儿(n=15)在哺乳期早期和后期(产后 2-4 个月)进行监测。在母乳喂养期间,同时记录吮吸时的负压、舌运动、呼吸、吞咽、氧饱和度和心率。
与哺乳期早期相比,婴儿在后期的哺乳时间更短,但转移的奶量相似(P=0.15)。与哺乳期早期相比,后期的吮吸爆发时间更长(P<0.001),暂停时间更短(P<0.001),负压水平降低(均 P<0.05),氧饱和度增加(P<0.001),心率降低(P<0.001)。
本研究证实,随着年龄的增长,足月婴儿在母乳喂养时变得更高效,主要通过延长吮吸爆发和减少暂停来实现。尽管婴儿在哺乳期早期表现出满意的 SSwB 协调性,但在后期表现出一定的适应或调节能力,通过施加较弱的负压水平和展示改进的心肺反应来实现。