Estimation of nutritive sucking during breast-feeding by receiver operating characteristic analysis of sucking interval

Abstract

　Herein, we describe our novel method for estimating nutritive sucking (NS) during breast-feeding using sucking intervals, as we had investigated its validity in the assessment of infant breast-feeding. We measured sucking pressure and swallowing sounds during maternal breast- and bottle-feeding in infants aged 1–2 months old. The sucking intervals when formula did and did not flow from the nipple during bottle-feeding were calculated, and receiver operating characteristic (ROC) analysis was used to calculate the cut-off value between these two conditions. Based on these sucking intervals, we classified the sucking of the infants as either over or under the estimated cut-off value. The averaged waveform of the swallowing-detected waveform that was triggered at the time when maximum sucking pressure was generated in each type of sucking was subsequently evaluated. The results of two-way analysis of variance showed that swallowing occurred significantly more often during sucking with sucking intervals that exceeded the cut-off value. This suggested that the use of this method could enable the estimation of NS from sucking intervals during breast-feeding rather than by measuring swallowing sounds.