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Is Yours Normal, Tips to Improve It, and More

What are some benefits of breastfeeding?

Breastfeeding not only creates a bond between you and your baby, it also provides your baby with nutrients that promote healthy growth.

Breast milk has antibodies that strengthen your baby’s immune system, protecting them from infections and diseases.

Breastfeeding also has long-term benefits. For example, breastfed babies are less likely to be obese or develop type 2 diabetes later in life.

Even if you’re convinced that breast milk is the best choice for your baby, you may have questions. Among your list of concerns, you may wonder whether your let-down reflex is normal. Find out more here.

What is the let-down reflex?

Between sore nipples, latching issues, and problems with milk flow, breastfeeding can be tricky. The let-down reflex, however, can make breastfeeding easier for both you and your baby.

“Let-down” is the release of milk from the breast. It’s a normal reflex that occurs when nerves in your breasts are stimulated, usually as a result of your baby sucking. This sets in motion a chain of events, and hormones are released into your bloodstream.

The hormone prolactin stimulates milk production, and the hormone oxytocin causes your breast to release or “let down” milk.

What is a normal let-down reflex?

Let-down, or the availability of milk, is different for every mother. Some women let down within seconds of their baby beginning to suck, but it takes others several minutes to let down. Therefore, you shouldn’t compare your reflex with another mother’s reflex.

Knowing what to expect during let-down can help you determine whether your reflex is normal.

Some breastfeeding mothers can feel their milk flow from their ducts to their nipples, but others don’t. You may notice different sensations in or around your breasts, such as:

• a tingling sensation, which feels like pins and needles
• a feeling of fullness
• milk leaking from your other breast

These sensations can develop immediately after giving birth, or they may not start until several weeks into breastfeeding. It varies from mother to mother.

Other bodily responses

Let-down can also trigger other natural responses. Although you may only feed your baby from one breast, let-down typically happens in both breasts simultaneously.

You shouldn’t be surprised if your other breast begins to leak. Also, don’t be alarmed if you feel your uterus contract when you let down. This is also normal.

Pacing

Your milk may let down at a slow and steady pace. Sometimes, however, let down is fast and forceful.

Your baby could choke if they suck too much milk at once. The flow of milk does gradually slow down, though, and it becomes more comfortable for your baby.

If you don’t want to risk your baby choking, use your hand and squeeze out a little milk before each feeding. Fast-flowing milk not only increases the likelihood of choking, but some people believe it can cause gas and colic.

Which actions can prompt let-down?

Let-down is a normal reflex when your baby sucks on your breasts, but it can also take place before your baby latches on. You may notice your milk let down when you hear your baby cry or if you’re overdue for a feeding.

Additionally, touching your breasts or using a breast pump can prompt let-down. This is called “expressing.”

How can you improve your let-down reflex?

Let-down comes easily and naturally for some breastfeeding mothers, but others have trouble getting their milk to flow.

If you have trouble with let-down — whether you’re feeding or expressing — there are several things you can do to help the process:

• sip on a warm beverage
• listen to soothing, calm music
• take a warm shower before feeding
• hold your baby close to your body
• gently massage your breasts to stimulate milk flow

What is the takeaway?

It’s important to remember that let-down is different for every person. You may have a physical response and feel tingling or fullness around the breasts every time milk is ready to flow, or you may feel nothing.

If you have concerns about your let-down reflex, talk to your doctor. Also, let your doctor know if you’re having pain during let-down. A painful let-down reflex isn’t unusual, and the pain typically goes away once you adjust to breastfeeding.

If pain doesn’t improve, it can be a sign of:

• a clogged milk duct
• a breast infection
• a strained muscle from giving birth
• your breasts producing too much milk

Study of oculomotor functions and their disorders in the Moscow Eye Clinic

To understand how the eyeball moves, it is necessary to understand the geometry of the eye and the functional tasks of the oculomotor muscles. The eyeball can rotate along three main axes - vertical (z), horizontal (y) and nasoccipital (x). The center of the eyeball is the point of intersection of these axes.

Eye rotations are provided by coordinated contractions and relaxation of six oculomotor muscles - four straight and two oblique each eye. The actions of the muscles of the eyeball are determined in the center of rotation of the eyeball, it also determines the course and attachment of each of the muscles. The movements of the eyeball and muscles are also influenced by the connective tissue formations (pulleys) of the extraocular muscles. A person performs at least 100,000 saccades with his eyes daily, so the oculomotor muscles are resistant to fatigue. From other skeletal muscles, the oculomotor muscles are also distinct. For example, the eye fibers are provided with multiple innervations, with each motor neuron (the smallest motor unit of the human body) innervating up to 10 or 20 muscle fibers.

Prices for treatment

Find out the price of the procedure, make an appointment at the "Moscow Eye Clinic" by calling 8 (800) 777-38 81 and (499) 322-36-36 (daily from 9:00 to 21:00 ) or using the online registration form.

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Basic eye movements

Monocular eye movements include inductions - these are movements of abduction, adduction, raising, lowering, turning the eyeball inward or outward.

Binocular friendly movements of both eyes are called versions, they are responsible for moving the visual axes in one direction. Versions - this is a simultaneous turn of the eyes to the left and right, raising and lowering them, rotational movements.

Binocular disjunctive movement is vergence, it provides movement of the visual axes of the eyes in opposite directions - convergence, divergence (divergence, with rotation).

Eye rotation is provided by the coordinated contraction of six muscles in each eye.

Functions of the muscles of the eyeball, determined by the center of rotation, the place of attachment and the course of each muscle. Through connective tissue formations located slightly behind the equator and 10 mm behind the points of attachment of the muscles, the tendons of the rectus muscles of the eye pass.

Connective tissue formations of the rectus muscles, consisting of smooth muscle fibers and fibrous tissue, which allows you to limit excessive movements during the rotation of the eyes.

The agonist muscle provides eye movement in a given direction, and the antagonist muscle produces eye movement in the opposite direction from the given direction.

According to Sherrington's law of reciprocal innervation, when the agonist muscle receives an excitation signal to begin contraction, at the same time, a suppression signal is sent to the antagonist muscle of that eye.

This reciprocal connection is due to central connections that exist in the brainstem. In one direction, the eyes move pairs of muscles, one from each eye. For example, the right outer straight line with the left inner straight line simultaneously contract when looking to the right.

In accordance with Hering's law of innervation identity, during eye movements of the same name, the pairs of synergist muscles receive the same signal and both eyes move together.

The vertically acting muscles are also paired (the right superior rectus pairs with the left inferior oblique and the right inferior rectus pairs with the left superior oblique). The nature of their interaction is very complex, because even with horizontal ordinary movements, all the muscles of the eye are involved.

Oculomotor functions

In clinical studies, all eye positions are determined: primary - when looking forward, as well as secondary position - when looking to the right, left, down and up. Tertiary positions up and left, down and left, up and right, down and right.

For example, the main elevator when looking to the right is the superior rectus muscle of the right eye, as well as the inferior oblique muscle of the left eye.

In this position, the right superior rectus muscle becomes the main elevator in the abduction of the right eye (under the influence of the external rectus muscle), due to its attachment to the eyeball with the formation of an angle with the visual axis of 23 degrees.

The left oblique inferior muscle becomes the main elevator during adduction of the left eye (under the action of the internal rectus muscle) due to its attachment to the eyeball and the formation of an angle of 51 degrees with the visual axis.

The cardinal positions of gaze in this case cannot correspond to the primary, secondary or tertiary action of the muscles. When the gaze of the right eye is directed to the right and upward, for raising or abducting the eyeball, the right superior rectus muscle is not responsible. The tertiary action of the superior rectus muscle is adduction, not abduction. When looking with the right eye upwards to the right, the lifting of the eyeball is provided by the contraction of the superior rectus muscle, while abduction is provided by the contraction of the external rectus muscle.

Among the main tasks of the motor system, it is customary to single out:

• Increasing the volume of observation when transforming the field of view into a fixation zone;
• Transferring images of objects of attention to the fovea with holding them;
• Ensuring the correct position of the eyes, for normal binocular vision.

Functional classification of eye movement systems, includes:

1. Fixation system: holds the image of a static object steadily for
   fossa, with a motionless head.
2. Optokinetic: Provides a stable retinal image during prolonged head movements.
3. Movements directing the fovea towards the object of interest and rapidly transferring the image of the object of interest to the fovea via saccades.
4. Drift: Image retention on the fovea of ​​a small moving target.
5. Vergences: moving the eyes in opposite directions (convergence or divergence) to hold the image of a single object on both pits at the same time.

Methods of clinical research

In the course of diagnosing oculomotor disorders, an anamnesis is first taken, which includes the patient's complaints. Then an examination is carried out, with a mandatory inspection of the state of the pupils, their reaction to light, the presence of anisoroots (the position of the head and chin), and the absence of nystagmus. The angle gamma (kappa) is detected and determined.

Important examination in the primary position of the eyes, checking their mobility in nine positions. Investigation of monocular movements (ductions) and binocular friendly movements (versions), detection of mobility disorders and assessment of possible muscle hyperfunction, respectively, of the corneal reflex in relation to the midline passing through the middle of the pupil.

Cover-test or Сover/uncover-test are important for determining preferred fixation, occult strabismus, unfriendly movements. The alternation test allows you to distinguish a clear deviation from a latent one and measure the tropia. The prism test measures apparent deviation by simultaneously occluding the fixing eye and placing the prism in front of the squinting eye. In the absence of a fixation movement, the value of the prism indicates the value of the angle.

For dissociated vertical strabismus (DVD), the Under-cover test will be used. It is performed with a prism and makes it possible to measure the apparent deviation. For its implementation, occlusion of the fixing eye is performed, and at the same time a prism is installed in front of the squinting eye. If there is no fixation movement, then the value of the prism is equal to the entire value of the angle.

When examining vergence, determine the close point of convergence on the synoptophore using prisms. Testing for diplopia, color test, Bagolini test, method of successive images are carried out.

For the study of phoria and fusion, a double Muddox test with an assessment of vertical strabismus or with a rotational component is used. In order to evaluate aniseikonia, a duochrome test and a Lancaster test are used to assess muscle balance.

Binocular vision is tested with Titmus test, Random test, Frisbee test and Lang test.

In case of obvious strabismus, to check visual functions, the measurement of the angle of deviation is carried out according to Hirschberg (the position of the corneal reflex relative to the pupillary edge). The Crimean test is performed (a prism placed in front of the squinting eye) and a test using a synoptophore.

For the study of vertical and horizontal saccades, the patient is asked to look from object to object 30 degrees on either side of the midline at a distance of 40 cm. Small saccades.

normal 1-5 deg, 200 ms. Saccades of 5-20 degrees indicate cerebellar disease and multiple sclerosis. Unclear fixation indicates disturbances in the stem centers of saccade and supranuclear regulation. To assess the state of the saccadic (fixation) system of the eyes, such tests are used: Devik, Griffin, etc.

Vestibular movements are assessed according to the following criteria: vestibular nystagmus increases without an object of fixation, with eyes closed during a test with a +20.0D lens with a visual acuity deterioration of one line (the study is carried out before and after turning the head left-right). A caloric test to determine the damage to the vestibular, nuclear and infranuclear pathways is carried out as follows: cold and warm water is instilled into the ear. Determines the state: with cold water (fast phase of OKN in the opposite direction from the ear), with warm water (fast phase of OKN towards the ear).

Optokinetic nystagmus (return of the image in the fovea in case of object movement) is examined with a rotating drum and subsequent assessment, nystagmus (its symmetry and direction of eye movement). Electronystagmography can also be used. Its indicators are violated in case of damage in the temporal and parietal areas of the brain, as well as in the vessels of the head and neck.

The condition of the eye muscles is assessed using electromyography.

The defining moment for a good test result is the level and choice of equipment, practical training of the doctor. The Moscow Eye Clinic employs specialists with a high level of practical training who own the equipment we have for vision diagnostics.

In our center, all patients can be examined using diagnostic equipment, and, based on the results, they can get advice from a specialist. We are open seven days a week and are open daily from 9 a.m. to 9 p.m.

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What is the sucking reflex? – Drink-Drink

Overview

Newborn babies are born with several important reflexes that help them in their first weeks and months of life. These reflexes are involuntary movements that occur either spontaneously or in response to various actions. For example, the sucking reflex occurs when a child touches the palate. The baby will start to suck when this area is stimulated, which helps with breastfeeding or bottle feeding.

Reflexes can be strong in some babies and weak in others depending on a number of factors, including how early the baby was born before due date. Read on to learn about the sucking reflex, its development, and other reflexes.

When does the sucking reflex occur?

The sucking reflex develops while the baby is still in the womb. Its earliest development is at the 32nd week of pregnancy. It usually develops fully by 36 weeks of gestation. You can even see this reflex in action during a routine ultrasound. Some babies will suck on their thumbs or hands, indicating that this important ability is developing.

Babies born prematurely may not have a strong sucking reflex at birth. They may also not have enough stamina to complete a feeding session. Premature babies sometimes need extra help to get their nutrients through a feeding tube, which is passed through the nose into the stomach. It can take weeks for a premature baby to coordinate sucking and swallowing, but many realize this by the time their initial due date is reached.

Sucking reflex and feeding

The sucking reflex occurs in two stages. When a pacifier - from a breast or from a bottle - is placed in the baby's mouth, he will automatically begin to suckle. When breastfeeding, the baby puts his lips on the areola and squeezes the nipple between the tongue and palate. They will use a similar motion when feeding a bottle.

The next stage occurs when the baby moves the tongue to the nipple to suckle, in effect milking the breast. This action is also called an expression. Suction helps to keep the breast in the baby's mouth during the process due to negative pressure.

Rooting versus the sucking reflex

There is another reflex that accompanies sucking called rooting. Babies will instinctively dig or search for the breast before suckling on it. Although the two reflexes are related, they serve different purposes. Rooting helps the baby find the breast and nipple. Suckling helps the baby extract breast milk for nourishment.

How to Test Your Baby's Sucking Reflex

You can test your baby's sucking reflex by placing a pacifier (breast or bottle), a clean finger or a pacifier in your baby's mouth. If the reflex is fully developed, the child should clasp the object with his lips, and then squeeze it rhythmically between the tongue and the palate.

Talk to your child's pediatrician if you suspect your child has problems with the sucking reflex. Since the sucking reflex is important for feeding, disruption of this reflex can lead to malnutrition.

Care problems and seeking help

Breathing and swallowing while suckling can be a difficult combination for premature babies and even some newborns. As a result, not all babies are professionals—at least not at first. However, with practice, children can master this task.

What you can do to help:

• Kangaroo care. Give your baby as much skin-to-skin contact or what is sometimes called a kangaroo as possible. This helps keep your baby warm and may even increase milk supply. The kangaroo method is not suitable for all children, especially children with certain medical conditions.
• Nursing wake-up call. Wake your child up every 2-3 hours to eat. Your healthcare provider can help you determine when you no longer need to wake your baby for feeding. Premature babies may need to be fed more often or woken up to eat longer than other babies.
• Take position. Keep your baby in the breastfeeding position, even if he is formula-fed. You can even try moistening cotton balls with breast milk and placing them next to your baby. The idea is to get them to recognize the smell of your milk.
• Try other positions. Experiment with holding your baby in different positions while breastfeeding. Some children do well in the “twin” (or “football hold”) position, where they are tucked under the arm and their body is supported by a pillow.
• Increase the downward reflex. Work on increasing the milk flush reflex that causes milk to come out. This will make it easier for the baby to express milk. You can massage, hand pump, or apply a warm compress to your chest to speed up the process.
• Stay positive. Try your best not to lose heart, especially in the early days. The most important thing is to get to know your child. Over time, they should begin to consume more milk with longer feedings.

Lactation Counselors

If you are having trouble breastfeeding, a certified lactation consultant (IBCLC) can also help. These specialists focus exclusively on feeding and everything related to nursing. They can help with anything from blockages and airway blockages to assessing and correcting other feeding issues such as positioning. They may suggest using a variety of devices, such as nipple shields, to help with a better latch.

Your baby's pediatrician, your OB/GYN or midwife can recommend a breastfeeding consultation. In the United States, you can find an IBCLC near you by searching the US Lactation Consultants Association database. You can request home visits, private consultations, or help at a breastfeeding clinic. You can also rent equipment such as hospital grade breast pumps. Some hospitals offer free consultations while you are in the delivery room or even after you have gone home.

Baby reflexes

Babies develop several reflexes to help them adjust to life outside the womb. In premature babies, the development of some reflexes may be delayed, or they may retain the reflex longer than average. Talk to your child's doctor if your child's reflexes are bothering you.

Root reflex

Sucking and digging reflexes go hand in hand. Your child will turn their head when they are stroked on the cheek or corner of their mouth. It's like they're trying to find a nipple.

To test the root reflex:

• Stroke your child's cheek or mouth.
• Follow rooting from side to side.

As your baby gets older, usually around three weeks of age, he will turn more quickly to the side being stroked. The rooting reflex usually disappears by 4 months.

Moro reflex

The Moro reflex is also known as the startle reflex. This is because this reflex often occurs in response to loud noises or movements, most commonly the sensation of falling backwards. You may notice that your child throws up his arms and legs in response to unexpected sounds or movements. After extension of the limbs, your child will contract them.

The Moro reflex is sometimes accompanied by crying. It can also affect your child's sleep by waking them up. Sometimes swaddling helps reduce the Moro reflex while the baby is sleeping.

To test the Moro reflex:

• Observe your child's reaction to loud sounds such as a barking dog.
• If your child jerks his arms and legs and then bends them back, this is a sign of the Moro reflex.

The Moro reflex usually disappears by 5-6 months.

Tonic neck

Asymmetric neck tone or “fencing reflex” occurs when your child's head is turned to one side. For example, if their head is turned to the left, the left arm will be extended while the right arm will be bent at the elbow.

To check neck tone:

• Gently turn the child's head to one side.
• Watch their hands move.

This reflex usually disappears by about 6-7 months of age.

The grasp reflex

The grasp reflex allows babies to automatically grab your finger or small toys when they place them in their palm. It develops in utero, usually around 25 weeks after conception. To test this reflex:

• Stroke your child's hand firmly.
• They should cling to your finger.

The grip can be quite strong and usually lasts until the child is 5-6 months old.

Babinski's reflex

Babinski's reflex occurs when the child's sole is rubbed hard. This causes the big toe to bend towards the top of the foot. The other fingers will also be splayed out. Test:

• Rub firmly on the bottom of your child's foot.
• Watch their toes fan out.

This reflex usually disappears by the time your child is 2 years old.

Step reflex

The step or “dance” reflex can cause your baby to be able to walk (with assistance) shortly after birth.

Test:

• Hold the child upright over a flat hard surface.
• Place the child's feet on the surface.
• Continue to give full support to your child's body and head and watch him take a few steps.

This reflex usually disappears by about 2 months of age.

Reflexes at a glance

Conclusion

Although babies do not have instructions for use, they do have a range of reflexes to help them survive the first weeks and months of life.

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