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Electromyographic activity of perioral muscle in breastfed and non-breastfed children
Abstract
The objective was to verify the electrical activity of the Mm. orbicularis oris and mentalis during suction of different liquids in breastfed and non-breastfed children from 2.5-3.5 years old. It was used a signal conditioner (MCS-V2-Lynx Eletrônica Ltda, SP, BR) and Beckman Ag-AgCl bipolar surface electrodes. Breastfed children presented higher activity for mentalis and smaller values for the M. orbicular oris than non-breastfed children, suggesting the existence of different profiles of muscle activation between them.
... Moreover, breastfeeding allows for oral maturation by stimulating muscle tone and the development of the temporomandibular joint, providing enough room for tooth eruption. [4][5][6][7][8][9][10][11][12] ORIGINAL ARTICLE Electromyography in natural and artificial feeding Gomes CF et al. Electromyography consists of the assessment of muscle function by analyzing the electrical signal produced during muscle contraction. ...
... With regard to the comparison between the groups as to the type of feeding, several studies show that the masseter is the muscle that most actively participates in breastfeeding, since it helps milk expression through jaw movements, more specifically by raising the jaw and protruding it, being regarded as a powerful muscle that is resistant to stretching. [5][6][7][8][9][10][11] According to Palmer, 16 Madeira 17 and Almeida et al., 18 jaw movements favor the appropriate growth and positioning of the jaw for tooth eruption. Therefore, the masseter plays a crucial role in infant feeding, which is accomplished only by breastfeeding and cup-feeding, because bottle-feeding reduces masseter activity, increases buccinator activity, reduces jaw movements, causes the tongue to retract, with possible hypoactivity and hyperactivity, depending on the type of sucking. ...
OBJECTIVE: To measure and compare the activity of the masseter, temporalis and buccinator muscles in different infant feeding methods METHODS: Cross-sectional study of 60 full-term infants with no intercurrent diseases, aged between two and three months, classified into the following groups: 1) exclusive breastfeeding; 2) breastfeeding plus bottle-feeding; and 3) exclusive breastfeeding plus cup feeding. Surface electromyography was performed during infant feeding. The Krushal-Wallis test was used, complemented by multiple paired comparisons of the groups. A 5% significance level was chosen for the tests. RESULTS: Statistically higher results were verified in the breastfeeding group in relation to the bottle-feeding one, both in the range of movement and the mean contraction of the masseter. With regard to the temporalis muscle, statistically higher results were found in the breastfeeding group comparatively to the bottle-feeding one. As to the buccinator muscle, statistically higher results were observed in the breastfeeding group in relation to the bottle-feeding one, although in this case, the difference concerned only the range of contraction. CONCLUSION: The similarities between the muscle activity in the breastfeeding and in the cup-feeding groups suggests that cup-feeding can be used as an alternative infant feeding method, being better than bottle-feeding, due to the hyperactivity of the buccinator muscle, which could result in changes to the structural growth and development of the stomatognathic system functions.
... Moreover, breastfeeding allows for oral maturation by stimulating muscle tone and the development of the temporomandibular joint, providing enough room for tooth eruption. [4][5][6][7][8][9][10][11][12] ORIGINAL ARTICLE Electromyography in natural and artificial feeding Gomes CF et al. Electromyography consists of the assessment of muscle function by analyzing the electrical signal produced during muscle contraction. ...
... With regard to the comparison between the groups as to the type of feeding, several studies show that the masseter is the muscle that most actively participates in breastfeeding, since it helps milk expression through jaw movements, more specifically by raising the jaw and protruding it, being regarded as a powerful muscle that is resistant to stretching. [5][6][7][8][9][10][11] According to Palmer, 16 Madeira 17 and Almeida et al., 18 jaw movements favor the appropriate growth and positioning of the jaw for tooth eruption. Therefore, the masseter plays a crucial role in infant feeding, which is accomplished only by breastfeeding and cup-feeding, because bottle-feeding reduces masseter activity, increases buccinator activity, reduces jaw movements, causes the tongue to retract, with possible hypoactivity and hyperactivity, depending on the type of sucking. ...
To measure and compare the activity of the masseter, temporalis and buccinator muscles in different infant feeding methods.
Cross-sectional study of 60 full-term infants with no intercurrent diseases, aged between two and three months, classified into the following groups: 1) exclusive breastfeeding; 2) breastfeeding plus bottle-feeding; and 3) exclusive breastfeeding plus cup feeding. Surface electromyography was performed during infant feeding. The Krushal-Wallis test was used, complemented by multiple paired comparisons of the groups. A 5% significance level was chosen for the tests.
Statistically higher results were verified in the breastfeeding group in relation to the bottle-feeding one, both in the range of movement and the mean contraction of the masseter. With regard to the temporalis muscle, statistically higher results were found in the breastfeeding group comparatively to the bottle-feeding one. As to the buccinator muscle, statistically higher results were observed in the breastfeeding group in relation to the bottle-feeding one, although in this case, the difference concerned only the range of contraction.
The similarities between the muscle activity in the breastfeeding and in the cup-feeding groups suggests that cup-feeding can be used as an alternative infant feeding method, being better than bottle-feeding, due to the hyperactivity of the buccinator muscle, which could result in changes to the structural growth and development of the stomatognathic system functions.
... The OO muscle is composed of different types of muscle fibers (Schiaffino & Reggiani, 2011), which can be grouped into two broad types (Pette & Staron, 1990): type I (slow twitch), characterized by small fiber diameter, resistance to fatigue, and slow contraction, and type II (fast twitch) with larger diameter, low resistance to fatigue, and fast contraction rate. Hence, the functional distribution of these muscle fiber types may modulate the OO muscle leading to change in shape of the lips and is integral to the actions of feeding (Jacinto-Goncalves, Gaviao, Berzin, de Oliveira, & Semeguini, 2004;Tamura, Matsushita, Shinoda, & Yoshida, 1998) and speaking (Raphael, Borden, & Harris, 2007;Rastatter & Dejarnette, 1984;Rastatter, McGuire, & Blair, 1987;Regalo et al., 2005;Standring, 2004). ...
Objective:
To pilot investigation of muscle fiber diameter (MFD) on medial and lateral sides of the cleft in 18 infants with cleft lip with or without cleft palate (CL/P) using image processing.
Material and methods:
Formalin-fixed paraffin embedded (FFPE) tissue samples from the medial and lateral sides of the cleft were analyzed for MFD using an image processing program (ImageJ). For within-case comparison a paired student's test was performed. For comparisons between classes an unpaired t-test was used.
Results:
Image processing enabled rapid measurement of MFD with majority of fibers showing diameter between 6 and 11μm. There was no significant difference in mean MFD between the medial and lateral sides, or between CL and CLP. However, we found a significant difference on the medial side (p=0.032) between males and females.
Conclusion:
The image processing on FFPE tissues resulted in easy quantification of MFD with finding of a smaller MFD on the medial side in males suggesting possible differences in OO muscle between the two sexes in CL that warrants replication using larger number of cases. Moreover, this finding can aid subclinical phenotyping and potentially in the restoration of the anatomy and function of the upper lip. This article is protected by copyright. All rights reserved.
... Bireyden bireye farklı görünümlere sahip olabilen dudaklar yüze estetik görünüm kazandırması yanında hareketleri nedeniyle yüz mimiklerinin oluşmasında, yiyeceklerin ağıza alınmasında ve konuşma sırasında önemli roller üstlenirler (48,49). ...
... This association may be explained, at least in part, by the purported role of breastfeeding as a promoter of healthy development of the muscles later responsible for masticatory function, particularly the masseter muscles [5,6,[21][22][23]. The cycle of movements performed by the child's jaws while sucking at the breast enables adequate growth and positioning of the jaws for proper tooth eruption [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], which, in turn, plays an essential role in learning to chew properly. Furthermore, children who breastfeed are less likely to be exposed to other forms of sucking, such as bottle-feeding and pacifier use [25], which are known to be deleterious to the development of the oral cavity [1,9,10]. ...
Background
There is some evidence of the benefits of breastfeeding to masticatory function, but no studies have evaluated the influence of breastfeeding duration on the quality of this function. The objective of this study was to investigate the association between duration of breastfeeding and quality of masticatory function in preschoolers.
Methods
Cross-sectional study nested in a contemporary cohort of 144 randomly selected Brazilian infants. Data on sociodemographic, dietary, and sucking-related parameters were collected shortly after birth and at 7, 30, 60, 120, and 180 days of life. Masticatory function was assessed between the ages of 3 and 5 years, using a standardized procedure involving three foodstuffs of different consistencies, for evaluation of incision, lip competence, masticatory patterns, masticatory movements, and perioral muscle use. The quality of masticatory function was scored, and multiple linear regression was used to test for association between this score and the duration of breastfeeding.
Results
A positive correlation was found between duration of breastfeeding and masticatory function scores (rs = 0.473; p < 0.001). Children breastfed for at least 12 months had significantly higher average scores, regardless of bottle-feeding or pacifier use. Children who were breastfed for longer were more likely to score satisfactorily across all tested parameters.
Conclusions
Breastfeeding has a positive impact on mastication. In our sample, duration of breastfeeding was positively associated with the quality of masticatory function at preschool age.
... These include respiratory, temporomandibular, and sleep dysfunctions, specific muscular activities in athletes and animals, the speech of children with occlusion alterations, and in evaluating infant feeding methods, specifically for verifying muscular activity during suckling and its possible implications in the growth of oral structures and their functional development. 5,6 sEMG can be used in scientific studies and clinical settings. Its importance in the clinical setting is related its ability to measure muscular activity during several feeding methods, as well as highlight the importance of breastfeeding, especially in preterm infants. ...
To evaluate studies that have used surface electromyography (sEMG) during feeding for term and preterm infants.
Studies published between 1996 and 2009 were identified through databases (MEDLINE, EMBASE, CINAHL, LILACS, and SciELO) and divided into groups: term infants, preterm infants, and other situations with infants aged from 0 to 12 months.
Five studies were found for suckling in term infants, two evaluating muscular activity during feeding in preterm infants, and one dealing with other situations. Some studies revealed striking differences in activity of the masseter muscle between breastfed and bottle-fed term infants (action diminished in bottle-fed infants). For preterm infants, authors evaluated sucking and sucking bursts and pointed out an effective means of evaluating muscle behaviour during feeding. There is evidence of a similarity in activity between cup feeding and breastfeeding.
Studies found in this literature review show the importance of using sEMG as a method of feeding assessment for term and preterm infants. For term infants, the masseter muscle presented greater muscular activity during breastfeeding and reduced activity during bottle-feeding. It was not possible to make comparisons between studies of preterm infants because of differences in methodological design.
... In general, contraction of both the pars marginalis and pars peripheralis fibers in humans produces change in the shape of the lips and the size of the opening of the oral cavity, actions used in feeding (Tamura et al. 1998;Jacinto-Gonçalves et al. 2004), communication via facial expressions (Ekman & Oster, 1979) and in the production of human speech (Rastatter & DeJarnette, 1984;Rastatter et al. 1987;Standring, 2004;Regalo et al. 2005;Raphael et al. 2007). ...
The orbicularis oris muscle plays a role in the production of primate facial expressions and vocalizations, nutrient intake, and in some non-human primates it is used as a prehensile, manipulative tool. As the chimpanzee (Pan troglodytes) is the closest living relative of humans, a comparison of the orbicularis oris muscle between these species may increase our understanding of the morphological specializations related to the differing functional demands of their lips and the factors responsible for their divergent evolution. To this end, this study compares the microanatomy of the mid-line upper fibers of the orbicularis oris muscle between chimpanzees and humans. A mid-line portion of the orbicularis oris muscle was harvested from the upper lips of three chimpanzee and five human cadavers. The sampled blocks included the area between the lateral borders of the nasal alar cartilages in both species. Each sample was processed for paraffin histology, sectioned and stained with a variety of protocols. Sections were examined for fiber direction and relative thickness of muscle layers. Ratios of cross-sectional connective tissue area vs. cross-sectional muscle tissue area, muscle fiber diameter and relative dermal thickness were calculated for each species. In both species, a clear pars marginalis layer was recognized, contrary to previous reports that only humans possess this layer. In chimpanzees, the relative fiber diameter and relative amount of muscle tissue (i.e. based on ratio of connective tissue area : muscle tissue area) were significantly (P < 0.05) greater than in humans. In contrast, measurements of relative dermal thickness showed that humans have a greater average dermal thickness of the upper lip than chimpanzees. Taken together, these results suggest that both human and chimpanzee orbicularis oris muscle upper fibers meet the specific functional demands associated with their divergent vocal and facial display repertoires, the development of human speech, and the use of the upper lip as a prehensile tool in chimpanzees.
... Indeed studies measuring orofacial muscle function have shown significantly reduced masseter muscle activity in bottle-fed infants [16]. Furthermore differences in perioral muscle function between breastfed and bottle-fed infants appear to persist into the second and third year of life [17]. It is interesting to note that significant reduction in growth of the mandible has been observed in bottle-fed mice compared to those suckled by the dam [18]. ...
The mechanism by which the breastfeeding infant removes milk from the breast is still controversial. It is unclear whether the infant uses predominantly intra-oral vacuum or a peristaltic action of the tongue to remove milk from the breast. The aim of this study was to use ultrasound to observe movements of the tongue during breastfeeding and relate these movements to both milk flow and simultaneous measurements of intra-oral vacuum.
Submental ultrasound scans of the oral cavity of 20 breastfed infants (3-24 weeks old) were performed during a breastfeed. Intra-oral vacuums were measured simultaneously via a milk-filled supply line (SNS) connected to a pressure transducer.
Vacuum increased during the downward motion of the posterior tongue and at the same time milk flow and milk ducts in the nipple was observed. Peak vacuum (-145+/-58 mmHg) occurred when the tongue was in the lowest position.
Ultrasound imaging demonstrated that milk flow from the nipple into the infant's oral cavity coincided with both the lowering of the infants tongue and peak vacuum. Therefore vacuum is likely to play a major role in milk removal from the breast.
The perspective provided by the lactation consultant related to infant feeding evaluation is from the viewpoint of taking into consideration the breastfeeding dyad, namely, the mother and infant. In order to provide a comprehensive assessment of feeding competency – including infant swallowing – both the maternal and infant conditions must be considered. This chapter will describe the key factors that influence maternal lactation and breastfeeding behavior in the infant during critical periods of development post-birth. Management strategies will be discussed that seek to optimize attachment to the breast and maternal milk production and to support breastfeeding to the extent possible when craniofacial conditions are present. Finally, the contributions the lactation consultant brings to the health-care team in managing the infant experiencing feeding problems will be reviewed.
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Relationship between breastfeeding duration and prevalence of posterior crossbite in the deciduous dentition. Kobayashi HM, Scavone H Jr, Ferriera RI, Garib DG. Amer J Orthod Dentofacial Orthop 2010;137:54-8. REVIEWER: Alan R. Milnes, DDS, PhD, FRCD(C) PURPOSE/QUESTION: The purpose of this cross-sectional investigation was to analyze the relationship between exclusive breastfeeding duration and the prevalence of posterior crossbite in the deciduous dentition. SOURCE OF FUNDING: Information not available TYPE OF STUDY/DESIGN: Cross-sectional study LEVEL OF EVIDENCE: Level 3: Other evidence STRENGTH OF RECOMMENDATION GRADE: Not applicable.
The activity of the perioral muscles during breastfeeding in infants was investigated using EMGs. Fifty-six infants aged from 1 to 5 months were classified into five groups according to month of age in the cross-sectional study. Follow-up was carried out on 18 infants whose mean age was 2.5 months at the initial examination, and 4.8 months at the second. During suckling, EMGs were recorded unilaterally from the temporalis (TM), the masseter (MM), the orbicularis oris (OM), and the suprahyoid (SM) muscle groups. The activity of the SM increased significantly with age, while there was no appreciable increase in the activity of the TM, MM, and OM in either the cross-sectional study or the follow-up. However, total muscle activity was shown to increase significantly in both parts of the study. These findings suggest that the active tongue- and jaw-lowering movement may play a primary role in increasing sucking strength during the suckle-feeding period in infants.
The aim of the present in-vivo study was to determine whether circumoral musculature could be imaged using an ultrasound with a high frequency probe and to record the changes, if any, in the thickness and shape of the images of the lips occurring amongst normal and different malocclusion states during the relaxed and contracted states. Thirty children with varying classes and types of malocclusion in the age group of 9-12 years were included in this investigation. A real time ultrasound system with a 10 MHz sector scan transducer was used to do the imaging. The results indicated that the circumoral region could be imaged ultrasonographically and that significant changes occurred in the thickness of this muscle in both relaxed and contracted states as well as in varying malocclusion states. Significant increase in muscle thickness was aslo noted in these subjects who were given muscle exercises. Long term observations utilizing this technique in following growth and age related changes will provide a wealth of information for clinical practice in future.
The activity of the perioral muscles during breastfeeding in infants was investigated using EMGs. Fifty-six infants aged from 1 to 5 months were classified into five groups according to month of age in the cross-sectional study. Follow-up was carried out on 18 infants whose mean age was 2.5 months at the initial examination, and 4.8 months at the second. During suckling, EMGs were recorded unilaterally from the temporalis (TM), the masseter (MM), the orbicularis oris (OM), and the suprahyoid (SM) muscle groups. The activity of the SM increased significantly with age, while there was no appreciable increase in the activity of the TM, MM, and OM in either the cross-sectional study or the follow-up. However, total muscle activity was shown to increase significantly in both parts of the study. These findings suggest that the active tongue- and jaw-lowering movement may play a primary role in increasing sucking strength during the suckle-feeding period in infants.
In this investigation, surface electromyographic (EMG) recordings were used to make qualitative and quantitative analyses of labial muscle activity during three swallowing tasks, incorporating the use of various drinking implements. EMG was recorded from four quadrants of the perioral region and from the submental muscle complex in 11 normal adult females. Swallowing tasks included liquid extraction from a spoon, a straw, and a cup and posterior bolus propulsion of a 5 ml, thin liquid. Average EMG values obtained during a maximal lip compression task were used to normalize labial muscle responses for each subject thus allowing between-subject comparisons. Variable activity patterns were noted in the perioral muscles once the lips were contacted by a drinking implement. Subjects used a greater percentage of maximal labial muscle activity to remove liquid from an implement than to swallow the liquid. A greater level of EMG was recorded in the lips during straw usage as compared with spoon or cup usage. Significant intrasubject and intersubject variability in labial function occurred during liquid removal using a drinking implement and during the oral swallow in these normal subjects.
The study group consisted of 19 subjects with positive overjet and overbite, and 17 subjects with skeletal open bite. Two bipolar surface electrodes were attached to the skin of the upper and lower lips. The mean integrated amplitude of the electromyographic (EMG) activity was obtained at the mandibular rest position with the lips in contact and with the lips apart. Subjects were divided into two groups based on positive or negative values of the difference in integrated EMG activity of the mentalis muscle between the two lip positions. Subjects displaying a negative value were classified as having competent lips and those displaying a positive value were classified as having incompetent lips. The EMG activity of the mentalis muscle was found to be more indicative of lip sealing as compared with the EMG activity of the depressor of the lower and the upper lips. The activities of the mentalis muscle at the mandibular rest position with the lips in contact and with the lips apart appear to offer an objective criterion for the evaluation of lip incompetence. In addition, the vertical dimension of the face, as well as the proclination of the incisors, appear to affect lower lip function.
Term infants are able to develop sucking behavior after birth. However, the requirements for this development have not yet been fully elucidated. In the present study, we investigated whether an oral-feed practice is necessary for the development of sucking behavior and whether non-nutritive sucking could support the development of this behavior while the infants cannot be fed.
Subjects of the present study were four term or near-term infants who had never been fed orally for approximately 2 months after birth because of gastrointestinal problems. Sucking pressure was measured with a silicone tube inserted into an artificial nipple and sucking efficiency was calculated during an entire feeding.
Sucking pressure, frequency and duration at the first time oral feed corresponded to values obtained for normal-term infants at their first oral feed. Although infants who had not received oral feeding demonstrated poor sucking abilities initially, sucking performance improved with practice. Sucking parameters measured 1 month since oral feeding was initiated in these infants corresponded to values obtained for normal-term infants at 1 month of age. Although infants who had not received oral feeding had often sucked a pacifier for sedation, this non-nutritive sucking did not result in the development of sucking behavior.
These results demonstrate that an oral feeding practice is necessary for the development of sucking behavior and that non-nutritive sucking does not affect the development of sucking.
Maturation of the Orofacial neuromusculatura
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