Related Experiment Videos
Coordination of breathing, sucking, and swallowing during bottle feedings in human infants
J S Koenig1, A M Davies, B T Thach
1Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, Children's Hospital, St. Louis, Missouri 63110.
Insights
Bottle feeding in infants can decrease ventilation due to airway closure during swallowing. This study reveals that airway closure, not breathing inhibition, is the main cause of reduced ventilation in infants during bottle feeding.
Area of Science:
- Pediatric respiratory physiology
- Infant feeding mechanics
Background:
- Bottle feeding in infants is associated with decreased ventilation.
- The precise temporal coordination between sucking, swallowing, breathing, and ventilation during infant bottle feeding remains unclear.
Purpose of the Study:
- To investigate the temporal coordination of sucks, swallows, and breaths during bottle feeding in healthy infants.
- To determine the mechanisms underlying decreased ventilation during infant bottle feeding.
Main Methods:
- Simultaneous recording of respiratory movements, airflow, intraoral, and intrapharyngeal pressures in 8 full-term and 5 preterm infants.
- Analysis of suck, swallow, and breath timing and their impact on minute ventilation.
Main Results:
- Sucking alone did not affect breathing or minute ventilation during nonnutritive sucking.
- Minute ventilation during bottle feeding was inversely related to swallow frequency.
- Swallows were associated with a 600 ms period of decreased respiratory initiation and a 530 ms airway closure.
- Obstructed breaths during prolonged airway closure were frequently observed.
Conclusions:
- Decreased ventilation during infant bottle feeding is primarily caused by airway closure during swallowing.
- Respiratory inhibition during swallows contributes to reduced ventilatory efforts.
Abstract:
Incoordination of sucking, swallowing, and breathing might lead to the decreased ventilation that accompanies bottle feeding in infants, but the precise temporal relationship between these events has not been established. Therefore, we studied the coordination of sucks, swallows, and breaths in healthy infants (8 full-term and 5 preterm). Respiratory movements and airflow were recorded as were sucks and swallows (intraoral and intrapharyngeal pressure). Sucks did not interrupt breathing or decrease minute ventilation during nonnutritive sucking. Minute ventilation during bottle feedings was inversely related to swallow frequency, with elimination of ventilation as the swallowing frequency approached 1.4/s. Swallows were associated with a 600-ms period of decreased respiratory initiation and with a period of airway closure lasting 530 +/- 9.8 (SE) ms. Occasional periods of prolonged airway closure were observed in all infants during feedings. Respiratory efforts during airway closure (obstructed breaths) were common. The present findings indicate that the decreased ventilation observed during bottle feedings is primarily a consequence of airway closure associated with the act of swallowing, whereas the decreased ventilatory efforts result from respiratory inhibition during swallows.