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Sharon Trotter RM BSc

Midwife, Breastfeeding Consultant and Neonatal Skincare Advisor

The Practising Midwife 2006 - breastfeeding

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Down-under view of breastfeeding research – Basel 2006

The full reference for this draft article is: Trotter S (2006). Around the Conferences - Down under view of breastfeeding research, Basel Switzerland. The Practising Midwife, 9(10): 25

I was lucky to be one of the delegates at a one day symposium held in the delightful city of Basel, Switzerland on 7 October 2006. The event was attended by over 300 devotees of breastfeeding from all corners of the globe. Together, we witnessed the dissemination of the latest research on human breast anatomy and its relevance to lactation, presented by keynote speaker Professor Peter Hartmann and his team from the University of Western Australia.

The results of this research, and its translation to clinical practice, should help us provide significantly better support to new mothers within the modern health care setting.

The symposium was sponsored by Berufsverband Schweizerischer Stillberaterinnen (BSS) – The Professional Association of Swiss Lactation Consultants and Medela AG was held at the impressive Congress Centre in Basel.

The day began with Professor Hartmann’s keynote speech. This gave the audience a fascinating insight into the evolutionary journey of the mammary gland and maternal/infant development. Following recent reports in the British press regarding raised IQ levels in breastfed infants, it was wonderful to hear Professor Hartman himself stating that not only does meta-analysis confirm, without doubt, that this is indeed the case, but also that the IQ of the mother is optimised during lactation. His pictures of aboriginal mothers and babies co-sleeping in the nude (close skin-to-skin contact keeps them from becoming hypothermic during the cold nights in the outback) were especially memorable. [back to top]

Next to speak was the newly married Dr Donna Ramsay whose pioneering ultrasound images of babies’ breastfeeding will stay with me forever. To see the relationship between the tongue and nipple, then watch the milk making its way from the soft to hard palate before being swallowed, in a beautifully rhythmic cycle, certainly took my breath away.

Studying these images of babies at the breast has lead to the conclusion that good co-ordination of three critical components: sucking, swallowing and breathing can ensure efficient and safe breastfeeding. Recently it has been shown that milk removal corresponds with both lowering of the infant tongue and increased vacuum in the term breastfeeding infant (Ramsay et al 2004).

The implications of this research on clinical practice were demonstrated next by Catherine Garbin, who only joined the lactation research team at the University of Western Australia10 months ago. Her background as a midwife and lactation consultant has equipped her to develop a new breastfeeding assessment tool. It is hoped this tool will lead to quicker diagnosis of breastfeeding problems so that a plan of action can be successfully expedited for mother and baby.

After a delicious lunch and networking with delegates the afternoon sessions concentrated on clinical scenarios and case studies to explain further how our new understanding of breast anatomy (Ramsay 2005) would impact on the relationship between science and practice. The major anatomical differences to come out of this research are the reduction in the number of milk ducts present in the human breast and the complete lack of lactiferous sinuses. This has implications for women who have had breast surgery and means that the ductal system is now accepted to be involved in the transport rather than storage of milk. [back to top]

Dr. Jacqueline Kent PhD and Catherine Garbin explained how the use of 24 hour milk production collections (Kent 2006) have lead to management plans for any given lactation problem. This demonstrates how research can be applied to real breastfeeding dyads to achieve successful outcomes in the clinical setting.
Mr Ching Lai rounded off the day with an overview of his work into the frequency, duration and milk production in preterm mothers as a way of optimising nutrition for those most vulnerable of infants.
There can be no doubt that, as a result of the dedication and tireless work shown by the team of experts at the University of Western Australia, we as midwives will come to benefit greatly from this new insight into human lactation and breast anatomy. It has already helped many new mothers to understand why seemingly simple problems can cause disruption to the enjoyment and establishment of breastfeeding. This excellent work can only result in enhancing the breastfeeding relationship for women everywhere.

Acknowledgment: I would like to thank Medela UK for inviting me to be one of their guests at the above symposium. [back to top]


Kent JC, Mitoulas LR, Cregan
MD, Ramsay DT, Doherty DA,
Hartmann PE (2006). Volume and frequency of breastfeeds and fat content of breastmilk throughout the day. Pediatrics, 117:e387- e395.

Ramsay DT, Mitoulas LR, Kent
JC and Hartmann PE (2004).
Ultrasound imaging of the sucking mechanics of the breastfeeding infant. 12th International Conference of the International Society for Research in Human
Milk and Lactation (ISRHML).
September 10-14th 2004, Queens College Cambridge, UK.

Ramsay DT, Kent JC, Hartmann
RA, Hartmann PE (2005).
Anatomy of the lactating human breast redefined with ultrasound imaging. Journal Anatomy, 206: 525-534
[back to top]

© Sharon Trotter 2013
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