The First Year of Human Life: Coordinating Respiration and Nutritive Swallowing
- 768 Downloads
This study provides the first documented report of the maturation of breathing-swallowing coordination during feeding in ten healthy term human infants through the first year of life. A total of 15,073 swallows were obtained across ten assessments between 48 h and 12 months of age. Midexpiratory swallows represented the dominant pattern of breathing-swallowing coordination within the first 48 h (mean = 45.4%), but the prevalence of this pattern declined rapidly in the first week to 29.1% (p = 0.012). Inspiratory-expiratory swallows increased with age (p < 0.001), particularly between 9 (37.0%) and 12 months (50.4%). Between 72.6% and 75.0% of swallows were followed by expiration in the latter 6 months, which is an adult-like characteristic. These data suggest that while postswallow expiration is a robust feature of breathing-swallowing coordination from birth, two major shifts in the precise patterns occur: the first after 1 week of postnatal feeding experience and the second between 6 and 12 months, most likely due to neural and anatomical maturation.
KeywordsBreathing-swallowing coordination Feeding Infant Deglutition Deglutition disorders
The authors thank the participants and their caregivers and the interraters Elizabeth Haughey, Li Pyn Leow, and Lauren Ragg. The authors also thank the Foundation for Research Science and Technology for financial support and the staff in the Medical Physics and Bioengineering Department and the Burwood Birthing Unit of the Canterbury District Health Board for their technical support and assistance in subject recruitment, respectively.
- 27.Hoppenbrouwers T, Hodgman JE, Harper RM, Hofmann E, Sterman MB, McGinty DJ: Polygraphic studies of normal infants during the first six months of life: III. Incidence of apnea and periodic breathing. Pediatrics 60(4):418–425, 1997Google Scholar
- 34.Poets CF, Stebbens VA, Alexander JR, Southall DP: Breathing patterns and heart-rates at 6 weeks and 2 years. Am J Dis Child 142(12):1393–1396, 1991Google Scholar
- 44.Laitman JT, Reidenberg JS: The human aerodigestive tract and gastroesophageal reflux: an evolutionary perspective. Am J Med 103(5A):S2–S8, 1997Google Scholar
- 46.Arvedson JC, Brodsky L: Pediatric Swallowing and Feeding: Assessment and Management, 2nd ed. (New York: Singular Publishing Group), 2002Google Scholar