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Early Hum Dev. 2013 Sep;89(9):635-41. doi: 10.1016/j.earlhumdev.2013.04.009. Epub 2013 May 18.

Real-time 3D ultrasound imaging of infant tongue movements during breast-feeding.

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Childhood Nutrition Research Centre, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.



Whether infants use suction or peristaltic tongue movements or a combination to extract milk during breast-feeding is controversial. The aims of this pilot study were 1] to evaluate the feasibility of using 3D ultrasound scanning to visualise infant tongue movements; and 2] to ascertain whether peristaltic tongue movements could be demonstrated during breast-feeding.


15 healthy term infants, aged 2 weeks to 4 months were scanned during breast-feeding, using a real-time 3D ultrasound system, with a 7 MHz transducer placed sub-mentally.


1] The method proved feasible, with 72% of bi-plane datasets and 56% of real-time 3D datasets providing adequate coverage [>75%] of the infant tongue. 2] Peristaltic tongue movement was observed in 13 of 15 infants [83%] from real-time or reformatted truly mid-sagittal views under 3D guidance.


This is the first study to demonstrate the feasibility of using 3D ultrasound to visualise infant tongue movements during breast-feeding. Peristaltic infant tongue movement was present in the majority of infants when the image plane was truly mid-sagittal but was not apparent if the image was slightly off the mid-sagittal plane. This should be considered in studies investigating the relative importance of vacuum and peristalsis for milk transfer.


Breast-feeding; Mechanism; Peristalsis; Three-dimensional (3D); Tongue movement; Two-dimensional (2D); Ultrasound

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