Department of Orthodontic Abstracts and Reviews

DRS. EGON NEIJSTADT AND JOSEPH 0. ~ZBY, NEW YORK CIW

All comlnunications concerning further information about abstracted material and the accept- ance of articles 01‘ books for consideration in this department should be addressed to Dr. Egon

Neustadt. 133 East Fifty-Eighth Street, New York City.

Breast F-ding and Bottle Feeding, .Abstracted from “Vom Stillen des Saeuglings” by K. F. Hoffmann, Deutsche Zahnaerztliche Wochensehrift, 1933, Berlin, Zentral-Verein deutscher Zahnaerzte.

One of the main objects of modern dentistry is the prevention of dental disease and dental abnormalities. Among preventive measures: the correct, nutrition of mother and child is preeminent. It should be instituted during the prenatal period and carefully supervised during t.he first two years of babyhood. Correct nutrition refers not only to quantity and quality of the food, but also to the manner in which it is partaken.

In bottle feeding and in mixed feeding, the use of a proper nipple is of great importance. It goes a long way in eliminating etiologic factors in the development of malocclusions. A study of the differences between breast. and bottle feeding demonst.rates the reasons supporting this statement.

When the baby sucks on the mother’s breast? its lips arc pressed t.ightly against the areola of the nipple and, in this manner, a vacuum is created in- side the mouth. During the sucking motion, thr mandible is lowered and pushed forward. The muscles of tongue, cheeks, lips and pharynx are called upon for a combined and vigorous a&ion. Through the pull of the muscles during their contraction, a hra.lthy stimulation is exerted upon the bones of jaws, mouth, and nose. Through the vacutrrn created in the mouth cavity, the secretion of saliva is facilitated; and the milk, therefore? is constantly mixed with saliva. This abundant flow of saliva again causes, through a reflex acation. a secretion of the glands in stomach and intestines.

The situation is quite different in artificial feeding. A vacuum in the mouth cavity is not being crea~ted because the lilts cannot make an air-tight contact with the average soft rubber nipple; if they did, they would com- press it entirely and the flow of milk would cease. For this reason, a,ir is con- tinuously being swallowed by t-he baby. Furthermore, the salivary glands have only a diminished secretion. The freding itself takes place at, a faster

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rate, because the hole in the nipple is usually too large. The swallowing of air, the diminished secretion of saliva, and the quick intake of milk lead to digestive disturbances often associated with bottle feeding.

Furthermore, the changed mechanical conditions have an undesirable influence upon the teeth and upon the development of the skull bones. EX-

periments have revealed that with the use of an ordinary nipple a pressure of 500 gm. is being exerted on the palate. The muscles of lips, cheeks? and pharynx, on the other hand, are not functioning sufficiently. Through the abnormally high pressure, the delicate bony tissues are being transformed, and the palat)e becomes higher, mainly in its middle portion. The nasal cavity is hereby narrowed in, and the septum may be caused to deviate. IKout11- breathing is not infrequently invited by these manifestations of abnormal function.

Several new types of nipples have been designed in order to overcome these detrimental changes. All of them have as their main purpose the best possible imitation of natural conditions. One of t,hese specially designed

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d R c Fig. 1.--A, normal breast ; B, breast during nursing ; C, “Natura” nipple.

nipples has an end which is thin and which has the same shape as the end of the human nipple. Then follows a much wider and more resistant rubber portion (Fig. 1). This compares with the areola of the human breast, and it contains a few tiny openings which are arranged very similar to the opening of the female milk ducts. (Several American manufacturers place similar products on the American market, for instance the nipples of the Davol line, and the Hygeia nipple with the extra wide bottle. Imported products are the ‘ ‘ Poupon ’ ‘- and the above described “Natura” nipple.)

Natural conditions are so closely reproduced in t,hese modified nipples, that no untoward effect,s are noticed if they are used in bottle feeding. Fur- thermore, they overcome a great difficulty in mixed feeding, when the mother’s milk is not sufficient in quantity, because the change from sucking at the mother’s breast to sucking at the new nipple is not st,riking enough to be noticed by the baby. The weaning of the baby is also made easier, as it is already used to exerting greater efforts in its food intake.

E.N.