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Development of pharyngo-esophageal physiology during swallowing in the preterm infant

N Rommel1, M van Wijk, B Boets

  • 1Centre for Pediatric & Adolescent Gastroenterology, Children, Youth & Women's Health Service, Women's and Children's Hospital, North Adelaide (SA), Australia. nathalie.rommel@med.kuleuven.be

Neurogastroenterology and Motility
|August 11, 2011
PubMed

Insights

Preterm infants show developing pharyngeal motility and upper esophageal sphincter (UES) function. Poor coordination between pharyngeal propulsion and UES relaxation in young infants impacts feeding effectiveness and hospitalization duration.

Area of Science:

  • Neonatal physiology
  • Swallowing biomechanics
  • Pediatric gastroenterology

Background:

  • Poor feeding is a primary cause of extended hospitalization for preterm infants.
  • Pharyngeal and upper esophageal sphincter (UES) function in preterm infants is poorly understood due to assessment challenges.

Purpose of the Study:

  • To investigate the developmental trajectory of pharyngeal motility.
  • To characterize upper esophageal sphincter (UES) function during nutritive swallowing in preterm infants.
  • To analyze the coordination between pharyngeal and UES activity.

Main Methods:

  • High-resolution manometry was employed to assess swallowing in 18 preterm infants.
  • Measurements were taken weekly from the first oral feeding attempt (31-32 weeks gestation) for four weeks.
  • Analysis included 980 swallows, characterizing pharyngeal and UES pressure dynamics.

Main Results:

  • An age-related increase in peak pharyngeal pressure was observed.
  • The time for UES relaxation decreased with age.
  • Youngest infants exhibited uncoordinated swallowing, with the UES not fully relaxed during peak pharyngeal propulsion.

Conclusions:

  • Swallowing physiology in preterm infants demonstrates developmental changes linked to feeding efficiency.
  • Immature pharyngeal pressures and poor coordination of pharyngeal propulsion with UES relaxation are common.
  • These findings may explain feeding difficulties, choking, and fatigue in infants under 34 weeks gestation.
Abstract

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