| Summary: | Bibliography: p. 84-99. === This study focuses on sucking patterns in the neonatal period, and their association with various mother-infant behaviours observed during breastfeeding. It uses as its framework the model of an active infant, whose behavioural repertoire influences the perceptions and actions of her/his caregiver, and is in turn modified by their responses. From a group of 193 neonates, assessed over a period of 9 months, the sucking patterns of 15 infants diagnosed as asphyxiated at birth, on the basis of an APGAR score of < 6 at 5 minutes, and a TSR of > 5 minutes, are presented. Various parameters of the sucking pattern are obtained from traces recorded by a suckometer, which simulates the breast-feeding situation as closely as possible. These are compared daily, from birth until the pattern stabilises, with 15 matched controls, who have uncomplicated birth histories. The behaviours of the mother-infant dyad during breastfeeding are then observed over 3 feeds, between 7 and 23 days after birth. It is argued on the basis of the sucking results, that the asphyxiated group of infants comprises two subgroups, whose sucking responses fall at either end of the normal burst pause spectrum. This separation appears to be substantiated by dissimilar behaviour trends during breastfeeding. The final picture which arises is that of a group of asphyxiated neonates who suck for long periods with few pauses, and do not actively interact with their mothers, who consequently stimulate them less and terminate breastfeeding earlier, than mothers in the second group. Infants in the latter show a sucking pattern characterised by short bursts and long intervals. Their mothers interact with them in ways which appear directed towards organising their erratic behaviours and over time their breastfeeding relations are observed to approximate those of their controls. It is concluded that discrepancies in early sucking patterns may reflect problems in integrative and adaptive mechanisms, which could continue to influence behaviour and relationships. While this can only be an exploratory study in terms of the numbers investigated, certain measures are suggested to support those mother-infant dyads who appear at risk for disengaged breastfeeding relationships. Finally, indications for further research are discussed.
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