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Swallowing dysfunction in very low birth weight infants with oral feeding desaturation

Jang Hoon Lee1, Yun Sil Chang, Hye Soo Yoo

  • 1Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.

World Journal of Pediatrics : WJP
|October 22, 2011
PubMed

Insights

Swallowing dysfunction is common in very low birth weight (VLBW) infants with feeding desaturation. Infants born at or before 28 weeks gestation are at higher risk, regardless of age at discharge.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Clinical Nutrition

Background:

  • Oral feeding desaturation is a concern in very low birth weight (VLBW) infants near discharge.
  • The modified barium swallow (MBS) test is used to assess swallowing function.
  • Identifying risk factors for swallowing dysfunction in VLBW infants is crucial.

Purpose of the Study:

  • To detect swallowing dysfunction using the MBS test in VLBW infants experiencing oral feeding desaturation.
  • To identify risk factors associated with swallowing dysfunction in this vulnerable population.

Main Methods:

  • Retrospective review of 41 VLBW infants referred for MBS testing due to significant oral feeding desaturation at or after 35 weeks postmenstrual age.
  • Comparison of infants with impaired airway protection (inadequate epiglottic closure, laryngeal penetration, tracheal aspiration) versus those without.

Main Results:

  • Swallowing dysfunction was detected in 11 infants (26.8%) via MBS testing.
  • Infants with impaired airway protection had a significantly lower gestational age at birth (≤ 28 weeks).
  • Postmenstrual age at testing was similar between groups.

Conclusions:

  • Swallowing dysfunction leading to aspiration is a significant cause of oral feeding desaturation in VLBW infants.
  • Infants born at or before 28 weeks gestation require careful swallowing assessment regardless of postmenstrual age.
  • Consider swallowing dysfunction in VLBW infants born extremely preterm presenting with feeding difficulties.
Abstract

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