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Oral and respiratory control for preterm feeding
1Department of Speech-Language-Hearing: Sciences and Disorders, Neuroscience, Human Biology, and Bioengineering Programs, University of Kansas, 1000 Sunnyside Avenue, Lawrence, Kansas 66045, USA. smbarlow@ku.edu
Current Opinion in Otolaryngology & Head and Neck Surgery
|April 17, 2009
Summary
Feeding difficulties are common in preterm infants. Understanding the development of suck-swallow-respiration coordination and brainstem networks can lead to new interventions for safe oral feeding and hospital discharge.
Area of Science:
- Neonatal physiology
- Neurodevelopmental disorders
- Pediatric feeding disorders
Background:
- Feeding competency is a significant challenge for neonatal intensive care unit (NICU) survivors.
- Oral feeding is a critical milestone for preterm infant discharge, and unresolved issues can persist into childhood.
Purpose of the Study:
- To review studies on the motor control and development of nonnutritive and nutritive suck, swallow, and respiration coordination in preterm infants.
- To understand the neurological underpinnings of feeding in preterm populations.
Main Methods:
- Review of existing literature on suck-swallow-respiration coordination in preterm infants.
- Analysis of studies investigating central pattern generator (CPG) networks in infant feeding.
Main Results:
- Functional linkages between suck-swallow and swallow-respiration develop during gestation but can be affected by sensory input and disease.
- Brainstem CPG networks mature at different rates, impacting cross-system interactions.
- Trigeminal afferent stimulation can prime CPG networks for improved ororhythmic interactions.
Conclusions:
- CPG control for suck, mastication, swallow, and respiration matures differentially.
- Interventions targeting cross-system CPG interactions can optimize experience-dependent mechanisms.
- These interventions aim to promote robust ororhythmic patterns and safe swallowing in preterm infants.
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