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Semin Speech Lang 2017; 38(02): 077-086
DOI: 10.1055/s-0037-1599105
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neonatal Feeding Behavior as a Complex Dynamical System

Eugene C. Goldfield
1   Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
,
Jennifer Perez
2   Feeding and Swallowing Program, Boston Children's Hospital, Boston, Massachusetts
,
Katherine Engstler
2   Feeding and Swallowing Program, Boston Children's Hospital, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

Publication Date:
21 March 2017 (online)

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Abstract

The requirements of evidence-based practice in 2017 are motivating new theoretical foundations and methodological tools for characterizing neonatal feeding behavior. Toward that end, this article offers a complex dynamical systems perspective. A set of critical concepts from this perspective frames challenges faced by speech-language pathologists and allied professionals: when to initiate oral feeds, how to determine the robustness of neonatal breathing during feeding and appropriate levels of respiratory support, what instrumental assessments of swallow function to use with preterm neonates, and whether or not to introduce thickened liquids. In the near future, we can expect vast amounts of new data to guide evidence-based practice. But unless practitioners are able to frame these issues in a systems context larger than the individual child, the availability of “big data” will not be effectively translated to clinical practice.

Keywords

Dynamical systems - sucking - synergy - emergence
 

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