Assoc. Prof. Donna Geddes

Research Associate Professor, School of Molecular Sciences, The University of Western Australia.

Associate Professor Geddes is internationally renowned for her novel work with ultrasound imaging that has revolutionised our understanding of the anatomy of the lactating breast, milk ejection and blood flow, as well as the infant’s sucking technique, suck-swallow-breathe co-ordination, gastric emptying and body composition of both the term and preterm infant. She has since expanded her range of research interests to include the synthesis and removal of milk from the breast, the composition of human milk and its impact on the growth and body composition of breastfed infants, the investigation of HM metabolites and the search for biomarkers that are indicative of breast dysfunction.

Abstract: Optimal infant development – it’s all about volume and dose of milk components

There is no doubt that human milk is the ultimate form of nutrition and protection for our human infants. In particular human milk regulates infant growth and development of body composition such that it is believed to reduce the risk of obesity, a precursor to most non-communicable diseases. The mechanisms by which human milk modulates growth and development still remain unclear. Past studies have shown that milk volume is a driver of infant growth but does not account for all of the variations demonstrated. Further, concentrations of human milk components rarely show a relationship with infant outcomes. Our research explains these counterintuitive findings demonstrating a relationship between the dose (24 hour intake) of specific components and development of infant body composition. To add to the complexity, however, there is increasing evidence that both the ability to produce a full milk supply and the concentration of components is impacted by maternal factors such as metabolic status and body composition. Pushing the envelope even further infant breastfeeding behaviour can be explained by these relationships to a certain extent. These results underscore the multidirectional signalling between the mother, infant and the environment and also highlights a window of plasticity in infant development where it may be possible to improve early life programming for better infant health outcomes.

Abstract: To snip or not to snip – does frenotomy improve breastfeeding outcomes?

Despite an unprecedented increase in both the diagnosis of infant tongue-tie and rates of frenotomy, still, very little evidence exists to support this procedure for improved feeding outcomes. It is only in the past year that detailed anatomy of the frenulum has been described in both adult and fetal cadavers. These findings have a profound impact on the understanding of how frenotomy may change the functional oral anatomy, classification of tongue-tie and infant sensation post frenotomy. These studies coupled with measurement of intra-oral vacuum and milk intake pre and post frenotomy at least in part explain the rise in complications and the low rates of breastfeeding post frenotomy.