{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T09:45:04Z","timestamp":1774691104600,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T00:00:00Z","timestamp":1589932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Knowledge of the breastfeeding swallow is limited by practical challenges. Radiation exposure to both mother and infant and the radiolucent properties of breastmilk make videofluoroscopy an unsuitable imaging modality. Furthermore, ultrasound is not ideal for capturing the complex 3\u2010dimensional functional anatomy of swallowing. In this study we explore the feasibility of using real\u2010time MRI to capture the breastfeeding swallow.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective observational study: Review of imaging from 12 normal infants (&lt;5\u2009months of age) and their mothers while breastfeeding using real\u2010time MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Static images were successfully captured in 11 infants and dynamic images in nine infants. This imaging modality confirms the dorsal surface of the infant's tongue elevates the maternal nipple to the hard palate, closing the space around the nipple with no air visible in the oral cavity during sucking and swallowing. We obtained dynamic imaging of mandibular movement with sucking, palatal elevation and pharyngeal constriction with swallowing, diaphragm movement with breathing and milk entering the stomach. Breastmilk was easily visualized, being high intensity on T2 sequences. Technical challenges were encountered secondary to infant movement and difficulties acquiring and maintaining midsagittal orientation. The similarity in tissue densities of the lips, tongue, nipple and hard palate limited definition between these structures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Real\u2010time MRI imaging was successful in capturing dynamic images of the breastfeeding swallow. However, technical and practical challenges make real\u2010time MRI unlikely at present to be suitable for swallow assessment in clinical practice. Advances in technology and expertise in dynamic image capture may improve the feasibility of using MRI to understand and assess the breastfeeding swallow in the near future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p><jats:bold>4.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.397","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T19:58:10Z","timestamp":1590004690000},"page":"572-579","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Imaging the breastfeeding swallow: Pilot study utilizing real\u2010time <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4214-7521","authenticated-orcid":false,"given":"Nikki","family":"Mills","sequence":"first","affiliation":[{"name":"Paediatric Otolaryngology Department Starship Children's Hospital  Auckland New Zealand"},{"name":"Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna\u2010Maria","family":"Lydon","sequence":"additional","affiliation":[{"name":"Centre for Advanced MRI, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Davies\u2010Payne","sequence":"additional","affiliation":[{"name":"Paediatric Radiology Department Starship Children's Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Keesing","sequence":"additional","affiliation":[{"name":"Paediatric Speech\u2010language Therapy Department Starship Children's Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna T","family":"Geddes","sequence":"additional","affiliation":[{"name":"School of Molecular Sciences, Faculty of Science University of Western Australia  Crawley WA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyed Ali","family":"Mirjalili","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004424-199110000-00005"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1319798111"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-10-6"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1677753"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-31-363-156"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334415626152"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1990.tb16928.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1987.tb02118.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-009-9241-0"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200007000-00012"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.03.027"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000245"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-016-9705-y"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000021473"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25641"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334415601093"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334412474864"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2003.tb00607.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2001.tb00381.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2006.tb01320.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/21681163.2014.933679"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.26296"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2017.10.011"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.23591"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-006-9026-7"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01628116"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2012.09.010"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200107000-00010"},{"key":"e_1_2_10_30_1","first-page":"1","article-title":"The superior labial frenulum in newborns: what is normal?","volume":"4","author":"Santa Maria C","year":"2017","journal-title":"Global Ped Health"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334413491325"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2007.12.008"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311200905"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-007-9093-4"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12135"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22496"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flio2.397","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.397","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lio2.397","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T03:53:41Z","timestamp":1693972421000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,20]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1002\/lio2.397"],"URL":"https:\/\/doi.org\/10.1002\/lio2.397","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,20]]},"assertion":[{"value":"2020-01-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}