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Thank you. Here is another public health crisis that very few people know about, on obstructive sleep apnoea:

🍼 Dr Brian Palmer (now deceased), whose decades of research were focused on malformation of the infant airway through the actions of intense infant bottle-feeding. Dr Palmer, who was a dentist, went so far to argue that obstructive sleep apnoea is essentially a modern disorder only, that it did not exist prior to the invention of the baby bottle in people of normal weight. Certainly, Dr Palmer's large lab collection of prehistoric skulls was testament to his claims, where the nasopharyngeal anatomy of these skulls proved to be significantly more accommodating than what is seen today in those who present with the modern airway. Below is my summary of how I understand the main aspects of Dr Palmer's work as well as the link to the website largely dedicated to his research.

Depending on intensity, frequency and duration, infant bottle-feeding can lead to oral cavity malformation. As a baby has soft, malleable bones, bottle-feeding, depending on the above three factors, can malform the maxilla through the implosion effect of sucking on a bottle. The outcome, then, can essentially be a high-arched hard palate and narrowed dental arch. With the consequent elevation of the hard palate and its narrowing, the posterior nasal accommodation above is then unavoidably compromised (as the roof of the mouth is also the floor of the nasal cavity). And with this reduced nasal accommodation, pneumatic pressure during sleep is reduced (due to a reduction in the volume of air) as well as there being a prevailing inefficacy in the exchange of gases - since any one sleep phase accordingly dictates the respiratory drive. Further, if the raising of the hard palate is extreme, the nasal septum above can collapse and deviate, causing further ventilation problems.

Another profoundly negative aspect of infant bottle-feeding, again, depending on the three factors as highlighted above, is where the epiglottis settles into an unnatural position in the airway after its natural descent. During the first few months of life, an infant is able to swallow breastmilk and breathe at the same time, and this is because the epiglottis is temporarily connected to the soft palate. Following this period, if a strong feeding infant is being intensively bottle-fed, the epiglottis can finally settle too low into the airway after its separation from the soft palate. The result here can mean not only a narrowed pharyngeal airway, but also an epiglottis that, apart from its primary function of capping the airway during swallow, cannot serve to properly brace the back of the tongue during sleep. Arguably, along with the high-arched hard palate problem, such an occurrence can lead to sleep apnoea and sleep hypopnoea - for life if left untreated; and, worse, in the case of the infant, SIDS.

Breastfeeding involves a peristaltic action of suck, hence breastfeeding is still far superior to any form of infant bottle-feeding, Dr Palmer had argued. Not all infants who are bottle-fed will necessarily end up with compromised airways; however, if a mother can make an informed choice to breastfeed (and given adequate time), then she has, along with the benefits of breastmilk, another very good reason to do so.

milkmatters.org.uk/cate…

When I once sent Dr Palmer’s research to scientists at the University of Sydney, Australia their reply was that empirical evidence of the cause, being that of intense infant bottle-feeding, would still be required. My suggestion was that when midwifery nurses check for cleft palate in newborns that they also examine the hard palate for anything that deviates from what should be low and wide in formation. Any degree of narrowing and elevation thereafter, in the months ahead, in previously confirmed normal maxillae, would surely then be proof of the effects of implosion. I didn’t hear back from the university.

Interestingly, in the Australian state of New South Wales, the NSW Health 2016 report on breastfeeding (link below) states the following: “Babies who are breastfed have higher IQ scores and better jaw development.” Better or ideal jaw development can only mean here normal jaw development, with anything less having to be regarded as abnormal jaw development. Further, abnormal jaw development, if indicative of malformation of the oral cavity, could well mean a less than patent airway. health.nsw.gov.au/kidsf…

David White, Australia