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Relationship between respiratory control and feeding in the developing infant

Martha J Miller1, Pakaphan Kiatchoosakun

  • 1Rainbow Babies and Children's Hospital, Division of Neonatology, 11100 Euclid Avenue, Cleveland, OH 44106-6010, USA. mjm8@po.cwru.edu

Seminars in Neonatology : SN
|March 31, 2004
PubMed

Insights

Infant feeding coordination involves complex muscle control for breathing and swallowing. While typically developed by 35 weeks, respiratory issues can interfere, and reflux doesn

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Pediatrics

Background:

  • Simultaneous breathing and feeding (suck-swallow-breathe) requires intricate muscle coordination.
  • This coordination involves the brainstem controlling buccopharyngeal and esophageal phases of feeding.
  • Development of these functions is generally complete by 35 weeks post-conceptional age but can be affected by pathology.

Purpose of the Study:

  • To elucidate the neural control mechanisms underlying infant feeding and respiration.
  • To understand the developmental trajectory of coordinated breathing and swallowing.
  • To investigate the relationship between gastro-oesophageal reflux and apnoea of prematurity.

Main Methods:

  • Review of neurophysiological mechanisms controlling deglutition and respiration.
  • Analysis of developmental milestones in infant feeding and swallowing.
  • Examination of the role of the brainstem in regulating feeding reflexes and esophageal function.

Main Results:

  • Brainstem nuclei control sequential muscle activity during the buccopharyngeal phase of feeding.
  • Lower esophageal sphincter tone is regulated by brainstem nuclei and modulated by respiratory drive.
  • Gastro-oesophageal reflux does not appear to be a common trigger for apnoea of prematurity.

Conclusions:

  • Coordinated breathing and feeding in infants rely on complex brainstem circuitry.
  • Disruptions in respiratory or neurological function can impair infant feeding coordination.
  • While reflux can be symptomatic, it is not a primary cause of apnoea in premature infants.

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