CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2019; 23(03): e343-e353
DOI: 10.1055/s-0039-1677753
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Swallowing Analyses of Neonates and Infants in Breastfeeding and Bottle-feeding: Impact on Videofluoroscopy Swallow Studies

1   Post Graduation Program in Speech, Language and Hearing Sciences (PEPG), Pontifícia Universidade Católica de São Paulo, São Paulo, SP, Brazil
,
Esther Mandelbaum Gonçalves Bianchini
1   Post Graduation Program in Speech, Language and Hearing Sciences (PEPG), Pontifícia Universidade Católica de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

27 June 2018

21 October 2018

Publication Date:
28 May 2019 (online)

Abstract

Introduction Dysphagia, when left untreated, can result in an increase in morbidity and mortality rates, especially among infants with history of life-threatening neonatal diseases. The videofluoroscopy swallowing study (VFSS) is considered the gold standard for the diagnosis of dysphagia. There are few imaging studies of infant swallowing based on videofluoroscopy, none of which were performed during breast-feeding.

Objective To analyze the similarities and differences in infant swallowing function –regarding the feeding method – breast or bottle – and the impact on videofluoroscopy findings.

Methods A retrospective study of 25 VFSSs of breastfeeding and bottle-feeding infants was performed. The studied variables were: oral capture and control; tongue versus mandible movement coordination; sucking pattern; mandible excursion; liquid flow; bolus retention; laryngeal penetration; tracheal aspiration; clearing of material collected in the pharynx; and gastroesophageal reflux (GER).

Results The study showed a statistically significant association between nipple/areole capture; oral control; sucking pattern; mandibular excursion; liquid flow and feeding method. The velar sealing deficit, the place that trigger the pharyngeal swallow, food retention in the pharyngeal recesses, laryngeal penetration and GER were also factors associated with the feeding method.

Conclusion The analysis of the swallowing characteristics of both feeding methods revealed significant differences between them, with an impact on the diagnosis in the VFSSs, especially regarding velar function.

 
  • References

  • 1 Bae SO, Lee GP, Seo HG, Oh BM, Han TR. Clinical characteristics associated with aspiration or penetration in children with swallowing problem. Ann Rehabil Med 2014; 38 (06) 734-741
  • 2 Vazquez JL, Buonomo C. Feeding difficulties in the first days of life: findings on upper gastrointestinal series and the role of the videofluoroscopic swallowing study. Pediatr Radiol 1999; 29 (12) 894-896
  • 3 Pikus L, Levine MS, Yang YX. , et al. Videofluoroscopic studies of swallowing dysfunction and the relative risk of pneumonia. AJR Am J Roentgenol 2003; 180 (06) 1613-1616
  • 4 Prasse JE, Kikano GE. An overview of pediatric dysphagia. Clin Pediatr (Phila) 2009; 48 (03) 247-251
  • 5 Davis NL, Liu A, Rhein L. Feeding immaturity in preterm neonates: risk factors for oropharyngeal aspiration and timing of maturation. J Pediatr Gastroenterol Nutr 2013; 57 (06) 735-740
  • 6 Tutor JD, Srinivasan S, Gosa MM, Spentzas T, Stokes DC. Pulmonary function in infants with swallowing dysfunction. PLoS One 2015; 10 (05) e0123125
  • 7 Mello-Filho FV, Mamede RCM, Duca-Silva AP. , et al. Videofluoroscopia da deglutição em crianças. In: Jotz GP, Carrara-De Angelis E, Barros APB. Tratado da deglutição e disfagia: no adulto e na criança. Rio de Janeiro: Revinter; 2009
  • 8 Dodrill P, Gosa MM. Pediatric Dysphagia: Physiology, Assessment, and Management. Ann Nutr Metab 2015; 66 (05) (Suppl. 05) 24-31
  • 9 Lefton-Greif MA, McGrattan KE, Carson KA, Pinto JM, Wright JM, Martin-Harris B. First Steps Towards Development of an Instrument for the Reproducible Quantification of Oropharyngeal Swallow Physiology in Bottle-Fed Children. Dysphagia 2018; 33 (01) 76-82
  • 10 Logeman JA. Evaluation and treatment of swallowing disorders. San Diego (CA): College-Hill Press; 1983
  • 11 Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev 2008; 14 (02) 118-127
  • 12 American Speech-Language-Hearing Association. Guidelines for Speech-Language Pathologists Performing Videofluoroscopic Swallowing Studies. ASHA Special Interest Division 13, Swallowing and Swallowing Disorders (Dysphagia).2002, 2004
  • 13 Martin-Harris B, Jones B. The videofluorographic swallowing study. Phys Med Rehabil Clin N Am 2008; 19 (04) 769-785 , viii
  • 14 Weckmueller J, Easterling C, Arvedson J. Preliminary temporal measurement analysis of normal oropharyngeal swallowing in infants and young children. Dysphagia 2011; 26 (02) 135-143
  • 15 Goldfield EC, Smith V, Buonomo C, Perez J, Larson K. Preterm infant swallowing of thin and nectar-thick liquids: changes in lingual-palatal coordination and relation to bolus transit. Dysphagia 2013; 28 (02) 234-244 . Doi: 10.1007/s00455-012-9440-y
  • 16 Stuart S, Motz JM. Viscosity in infant dysphagia management: comparison of viscosity of thickened liquids used in assessment and thickened liquids used in treatment. Dysphagia 2009; 24 (04) 412-422
  • 17 Ekberg O, Stading M, Johansson D, Bülow M, Ekman S, Wendin K. Flow properties of oral contrast medium formulations depend on the temperature. Acta Radiol 2010; 51 (04) 363-367 . Doi: 10.3109/02841851003645751
  • 18 López CP, Chiari BM, Goulart AL, Furkim AM, Guedes ZC. Assessment of swallowing in preterm newborns fed by bottle and cup. CoDAS 2014; 26 (01) 81-86
  • 19 Cichero J, Nicholson T, Dodrill P. Liquid barium is not representative of infant formula: characterisation of rheological and material properties. Dysphagia 2011; 26 (03) 264-271
  • 20 Frazier J, Chestnut AH, Jackson A, Barbon CE, Steele CM, Pickler L. Pickler l. Understanding the viscosity of liquids used in infant dysphagia management. Dysphagia 2016; 31 (05) 672-679
  • 21 Lima GM S. Métodos especiais de alimentação: copinho – relactação – translactação. In: REGO, J. D. Aleitamento materno. São Paulo, Rio de Janeiro, Belo Horizonte: Atheneu; 2000: 265-278
  • 22 Elad D, Kozlovsky P, Blum O. , et al. Biomechanics of milk extraction during breast-feeding. Proc Natl Acad Sci U S A 2014; 111 (14) 5230-5235
  • 23 Mercado-Deane MG, Burton EM, Harlow SA. , et al. Swallowing dysfunction in infants less than 1 year of age. Pediatr Radiol 2001; 31 (06) 423-428
  • 24 Hayoun P, Engmann J, Mowlavi S, Le Reverend B, Burbidge A, Ramaioli M. A model experiment to understand the oral phase of swallowing of Newtonian liquids. J Biomech 2015; 48 (14) 3922-3928
  • 25 Schrank W, Al-Sayed LE, Beahm PH, Thach BT. Feeding responses to free-flow formula in term and preterm infants. J Pediatr 1998; 132 (3 Pt 1): 426-430
  • 26 German RZ, Crompton AW, Owerkowicz T, Thexton AJ. Volume and rate of milk delivery as determinants of swallowing in an infant model animal (Sus scrofia). Dysphagia 2004; 19 (03) 147-154
  • 27 Ardran GM, Kemp FH, Lind J. A Cineradiographic study of breast feeding. Br J Radiol 1958; 31 (363) 156-162
  • 28 Weber F, Woolridge MW, Baum JD. An ultrasonographic study of the organisation of sucking and swallowing by newborn infants. Dev Med Child Neurol 1986; 28 (01) 19-24
  • 29 Bosma JF, Hepburn LG, Josell SD, Baker K. Ultrasound demonstration of tongue motions during suckle feeding. Dev Med Child Neurol 1990; 32 (03) 223-229
  • 30 Eishima K. The analysis of sucking behaviour in newborn infants. Early Hum Dev 1991; 27 (03) 163-173
  • 31 Geddes DT, Sakalidis VS. Ultrasound Imaging of Breastfeeding--A Window to the Inside: Methodology, Normal Appearances, and Application. J Hum Lact 2016; 32 (02) 340-349 . Doi: 10.1177/0890334415626152 Review
  • 32 Sakalidis VS, Geddes DT. Suck-Swallow-Breathe Dynamics in Breastfed Infants. J Hum Lact 2016; 32 (02) 201-211 , quiz 393–395
  • 33 Nowak AJ, Smith WL, Erenberg A. Imaging evaluation of artificial nipples during bottle feeding. Arch Pediatr Adolesc Med 1994; 148 (01) 40-42
  • 34 Newman LA, Keckley C, Petersen MC, Hamner A. Swallowing function and medical diagnoses in infants suspected of Dysphagia. Pediatrics 2001; 108 (06) E106
  • 35 Goldfield EC, Buonomo C, Fletcher K. , et al. Premature infant swallowing: patterns of tongue-soft palate coordination based upon videofluoroscopy. Infant Behav Dev 2010; 33 (02) 209-218
  • 36 Cassiani RA, Santos CM, Parreira LC, Dantas RO. The relationship between the oral and pharyngeal phases of swallowing. Clinics (São Paulo) 2011; 66 (08) 1385-1388
  • 37 Rossi MS, Buhler KE, Ventura GA, Otoch JP, Limongi SC. Laryngeal cleft type I in neonate: case report. CoDAS 2014; 26 (05) 421-424
  • 38 Leonard RJ, White C, McKenzie S, Belafsky PC. Effects of bolus rheology on aspiration in patients with Dysphagia. J Acad Nutr Diet 2014; 114 (04) 590-594
  • 39 Newman R, Vilardell N, Clavé P, Speyer R. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD). Dysphagia 2016; 31 (02) 232-249 . Doi: 10.1007/s00455-016-9696-8