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The first year of human life: coordinating respiration and nutritive swallowing
Bronwen N Kelly1, Maggie-Lee Huckabee, Richard D Jones
1Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.
Insights
Breathing-swallowing coordination in infants matures significantly in the first year. Key shifts occur after the first week and between 6-12 months, developing adult-like feeding patterns.
Area of Science:
- Pediatrics
- Neuroscience
- Developmental Biology
Background:
- Breathing-swallowing coordination is vital for safe infant feeding.
- Understanding its maturation is crucial for identifying developmental milestones.
Purpose of the Study:
- To document the maturation of breathing-swallowing coordination in healthy human infants.
- To identify specific developmental shifts in this coordination during the first year of life.
Main Methods:
- Longitudinal study of ten healthy term infants.
- Analysis of 15,073 swallows across ten assessments from 48 hours to 12 months.
- Categorization of breathing-swallowing patterns, including midexpiratory and inspiratory-expiratory swallows.
Main Results:
- Midexpiratory swallows dominated initially but declined rapidly within the first week.
- Inspiratory-expiratory swallows increased significantly with age, especially between 9 and 12 months.
- Post-swallow expiration, an adult-like trait, was observed in 72.6-75.0% of swallows in the latter 6 months.
Conclusions:
- Post-swallow expiration is present from birth but coordination patterns evolve.
- Two major shifts in breathing-swallowing coordination occur: post-1 week and between 6-12 months.
- These changes are likely driven by neural and anatomical maturation during infancy.
Abstract:
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.
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