Nipple position is believed to influence breastfeeding success. To investigate this belief, submental ultrasound images were obtained during breastfeeding of normal term infants. This study measured nipple to hard-soft palate distance (NHSPD) in 18 mother-infant pairs during the first and fourth weeks of life. Median NHSPD was 5 mm (interquartile: 4, 6 mm). There were no significant differences in median NHSPD between first, second, and fifth minutes of feeding (P = .675) or between week 1 and week 4 (P = .320). The nipple was not stationary during feeding, with mean nipple movement of 4.0 ∓ 1.3 mm. Further research is required with more infants to confirm the boundaries of normality for ultrasound measurements of nipple position during successful breastfeeding.
Woolridge MW.Aetiology of sore nipples. Midwifery. 1986;2: 172-176.
2.
Woolridge MW.The ‘anatomy’ of infant sucking. Midwifery. 1986;2: 164-171.
3.
Escott R.Positioning, attachment and milk transfer. Breastfeeding Rev. 1989;1: 31-37.
4.
Bu’Lock F, Woolridge MW, Baum JD.Development of co-ordination of sucking, swallowing and breathing: ultrasound study of term and preterm infants. Dev Med Child Neurol. 1990;32: 669-678.
5.
Binns CW, Scott JA.Breastfeeding: reasons for starting, reasons for stopping and problems along the way. Breastfeeding Rev. 2002;10: 13-19.
6.
Ardran GM, Kemp FH, Lind J.A cineradiographic study of breast-feeding. Br J Radiol. 1958;31: 156-162.
7.
Drewett RF, Woolridge MW.Sucking patterns of human babies on the breast. Early Hum Dev. 1979;3: 315-320.
8.
Smith WL, Erenberg A, Nowak A, Franken EA Jr.Physiology of sucking in the normal term infant using real-time ultrasound. Radiology. 1985;156: 379-381.
9.
Weber F, Woolridge MW, Baum JD.An ultrasonographic study of the organisation of sucking and swallowing by newborn infants. Dev Med Child Neurol. 1986;28: 19-24.
10.
Nowak AJ, Smith WL, Grenberg A.Imaging evaluation of breastfeeding and bottlefeeding systems. J Pediatr. 1995;126: S130-S134.
11.
Smith WL, Erenberg A, Nowak A.Imaging evaluation of the human nipple during breastfeeding. Am J Dis Child. 1988;142: 76-78.
12.
Ayano R, Tamura F, Ohtsuka Y, Mukai Y.The development of normal feeding and swallowing: Showa University study of the feeding function. Int J Orofacial Myol. 2000;26: 24-32.
13.
Peng CL, Jost-Brinkmann PG, Miethke RR, Lin CT.Ultrasonographic measurement of tongue movement during swallowing. J Ultrasound Med. 2000;19: 15-20.
14.
Ramsay DT, Kent JC, Owens RA, Hartmann PE.Ultrasound imaging of milk ejection in the breast of lactating women. Pediatrics. 2004; 113: 361-367.
15.
Righard L, Alade MO.Sucking technique and its effects on success of breastfeeding. Birth. 1992;19: 185-189.
16.
Glass RP, Wolf LS.Incoordination of sucking, swallowing and breathing as an etiology for breastfeeding difficulty. J Hum Lact. 1994;10: 185-189.
17.
Prieto CR, Cardenas H, Salvatierra AM, Boza C, Montes CG, Croxatto HB.Sucking pressure and its relationship to milk transfer during breastfeeding in humans. J Reprod Fertil. 1996;108: 69-74.
18.
Turgeon-O’Brien H, Lachapelle D, Gagnon PF, Larocque I, Maheu-Robert LF.Nutritive and non nutritive sucking habits: a review. ASDC J Dent Child. 1996;63: 321-327.
19.
Daly SE, Hartmann PE.Infant demand and milk supply. Part 1: infant demand and milk production in lactating women. J Hum Lact. 1995;11: 21-26.
20.
Butte N, Wills C, Jean CA, Smith EO, Garza C.Feeding patterns of exclusively breastfed infants during the first four months of life. Early Hum Dev. 1985;12: 291-300.
21.
Neifert M, DeMarzo S, Seacat J, Young D, Leff M, Orleans M.The influence of breast surgery, breast appearance, and pregnancy induced breast changes on lactation sufficiency as measured by infant weight gain. Birth. 1990;17: 31-38.
22.
Gunn A, Gunn TK, Rabone DL, Breier BH, Blum WF, Gluckman PO.Growth hormone increases breast milk volumes in mothers of preterm infants. Pediatrics. 1996;98: 279-282.
23.
Arthur PG, Hartmann PE, Smith M.Measurement of the milk intake of breast-fed infants. J Pediatr Gastroenterol Nutr. 1987;6(5): 758-763.
24.
Jacobs LA.Feeding ultrasound—a tool for lactation specialists. In: Australasian Society for Ultrasound in Medicine [Proceedings of Annual Scientific Conference]. Perth; 2003.
25.
Lucas A, Lucas PJ, Baum JD.Pattern of milk flow in breastfed infants. Lancet. 1979;2(8133): 57-58.
26.
SAS/STAT User’s Guide. Version 8. Cary, NC: SAS Institute Inc.; 2000
27.
Altman DG.Practical Statistics for Medical Research. London, UK: Chapman and Hall; 1991.
28.
Woolridge MW, Howe TV, Drewett RF, Rolf P, Baum JD.The continuous measurement of milk intake at a feed in breastfed babies. Early Hum Dev. 1982;6: 365-373.
29.
Lawrence RA.Breastfeeding: A Guide for the Medical Profession. St Louis, Mo: Mosby-Year Book; 1994.
30.
Kent JC, Ramsay DT, Doherty D, Larsson M, Hartmann PE.Response of breasts to different stimulation patterns of an electric breast pump. J Hum Lact. 2003;19: 179-186.
31.
L’Esperance C.Pain or pleasure: the dilemma of early breastfeeding. Birth. 1980;7: 21-26.
