Nasopharyngeal reflux and neonatal apnea

Although oropharyngeal dysfunction has been reported as a cause of dysphagia in newborns, to our knowledge oropharyngeal dysfunction and neonatal apnea have not been associated previously. We studied two infants in whom apnea and bradycardia developed primarily while feeding. The diagnosis was established by observation of the swallowing mechanism using cinefluoroscopy while the infant ingested a dilute barium meal. Thickened formula feedings and use of a special nipple resulted in complete cessation of apnea and bradycardia. Careful attention to the details that surround episodes of apnea is essential so that morbidity and mortality from treatable causes of apnea can be minimized.