title: Infants of mothers with persistent nipple pain exert strong sucking vacuums.
abstract: OBJECTIVE
  The objective of this study was to determine whether infants of mothers experiencing persistent nipple pain exerted very strong intraoral vacuums during a breastfeed.
  
  
  METHODS
  Thirty mothers experiencing persistent pain during breastfeeding (Pain group; infants aged 49.4 +/- 35.5 days) were compared to 30 successfully breastfeeding mothers (Control group; infants aged 55.0 +/- 22.7 days). Infant intraoral vacuums were measured via a small milk-filled tube taped alongside the nipple and connected to a pressure transducer. Milk intake was measured using the test weigh method.
  
  
  RESULTS
  Infants in the Pain group applied significantly stronger baseline (-90.8 +/- 54.5 vs. -56.4 +/- 31.4 mmHg, p = 0.004), peak (-214.3 +/- 60.5 vs. 163.2 +/- 62.4 mmHg, p = 0.002) and pause vacuums (-104.8 +/- 67.9 vs. -45.8 +/- 30.3 mmHg, p < 0.001). Despite similar active sucking times (377.5 +/- 175.2 vs. 349.4 +/- 184.0 sec, p = 0.554) the mean milk intake was significantly lower for infants of mothers with nipple pain (41.6 +/- 31.3 vs. 70.7 +/- 30.7 g, p = 0.001).
  
  
  CONCLUSIONS
  Infants of breastfeeding mothers experiencing persistent nipple pain applied significantly higher vacuum to the breast during breastfeeding despite assistance with positioning and attachment from a lactation consultant. Further investigation into the cause of the abnormally high vacuums is essential to develop successful interventions for these mother-infant dyads.
authors.affiliation: School of Biomedical, Biomolecular and Chemical Sciences, The University of Western Australia, Crawley, Western Australia, Australia. hlm@student.uwa.edu.au
authors.forename: Hl
authors.initials: H
authors.lastname: McClellan
authors.forename: Dt
authors.initials: D
authors.lastname: Geddes
authors.forename: Jc
authors.initials: J
authors.lastname: Kent
authors.forename: Cp
authors.initials: C
authors.lastname: Garbin
authors.forename: Lr
authors.initials: L
authors.lastname: Mitoulas
authors.forename: Pe
authors.initials: P
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002149:Energy Intake; D005260:Female; D006801:Humans; D007223:Infant; D008895:Milk, Human; D009558:Nipples; D010146:Pain / Q000209:etiology*; D013391:Sucking Behavior / Q000502:physiology*; D013997:Time Factors; D014886:Weaning; D014904:Western Australia