Swallow–Breath Interaction and Phase of Respiration with Swallow during Nonnutritive Suck among Low-risk Preterm Infants

Eric W Reynolds; Debbie Grider; Rhonda Caldwell; Gilson Capilouto; Pooja Vijaygopal; Abhijit Patwardhan; Richard Charnigo

doi:10.1055/s-0030-1262504

American Journal of Perinatology, Table of Contents

Am J Perinatol 2010; 27(10): 831-840
DOI: 10.1055/s-0030-1262504

Swallow–Breath Interaction and Phase of Respiration with Swallow during Nonnutritive Suck among Low-risk Preterm Infants

Eric W. Reynolds¹ , Debbie Grider¹ , Rhonda Caldwell¹ , Gilson Capilouto² , Pooja Vijaygopal³ , Abhijit Patwardhan³ , Richard Charnigo⁴

¹Division of Neonatology, Kentucky Children's Hospital, Lexington, Kentucky
²Division of Communication Sciences and Disorders, Lexington, Kentucky
³Center for Biomedical Engineering, Lexington, Kentucky
⁴Department of Biostatistics, University of Kentucky, Lexington, Kentucky

Abstract

ABSTRACT

This study describes swallow–breath interaction and phase of respiration with swallow during nonnutritive suck (NNS) in low-risk preterm infants. Suckle and swallow, thoracic motion, and airflow were measured in 16 infants during NNS. Logistic regression models were used to describe swallow–breath interaction and phase of respiration with swallow. One hundred seventy-six swallows occurred in 35 NNS periods. Swallow–breath interaction occurred as: central apnea (CA), obstructive apnea (OA), or attenuated respiration (AR). AR was associated with increased weeks post–first nipple feeding. OA occurred less often in males and with increased weeks post–first nipple feeding. In looking at the phase of respiration, more swallows occurred at beginning expiration with increased gestational age, increased weeks post–first nipple feed, and increased weeks before first nipple feed. More swallows occurred at midexpiration with more swallows per study, increased birth weight (BWT), and weeks before first nipple feed. Fewer swallows occurred at end expiration with increased weeks before first nipple feed. Fewer swallows occurred at midinspiration with increased swallows per study. Fewer swallows occurred at apnea with increasing BWT, more occurred with increased swallows per study. In low-risk preterm infants, swallow–breath interaction progresses from CA and OA to AR. The phase of respiration with swallow shows a maturation progression.

KEYWORDS

Nonnutritive suck - feeding behavior

Full Text

References

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Eric W ReynoldsM.D. M.P.H.

Division of Neonatology, Kentucky Children's Hospital

800 Rose St, MS 477, Lexington, KY 40536

Email: ereyn2@uky.edu