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Maturation of Infant Oral Feeding Skills

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Pediatric Dysphagia

Abstract

With the increased survival of infants born prematurely comes the awareness that many of them struggle to safely and competently feed by mouth. This is not unexpected as these infants’ functional physiological systems programmed for an in utero environment are not yet appropriate for their ex utero world. As these infants’ responses to any feeding difficulty most often fall into a nonspecific category of behaviors, e.g., feeding refusal, disorganization, or adverse events, e.g., oxygen desaturation and apnea/bradycardia, it is difficult for caregivers to identify the origins of these symptoms in order to arrive at a differential diagnosis and develop a management plan. As research on the development of infant oral feeding skills has advanced over the last two decades, this chapter is a review of our latest understanding of the maturation of infant oral feeding skills and the work that still lies ahead. Although we have gained some understanding of the maturation process of the individual functions implicated in the transport of a bolus from the oral cavity to the stomach, namely, sucking, swallowing, respiration, and esophageal function, there is a lack of understanding as to how the coordination of these functions needs to occur in order to ensure safety and efficiency for these infants during feeding.

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Abbreviations

CPG :

Central pattern generator

EB:

Esophageal body

GA:

Gestational age

LES:

Lower esophageal sphincter

NICU :

Neonatal intensive care unit

NSP:

Nutritive sucking pathway

PMA:

Postmenstrual age

SLOSR:

Swallow-induced lower esophageal sphincter relaxation

TLOSR:

Transient lower esophageal sphincter relaxation

UES:

Upper esophageal sphincter

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Acknowledgments

The author wishes to thank all the mothers and infants who generously participated in her studies, her many collaborators who have supported her work over the years, and the National Institutes of Health for the support (R01 HD-28140; R01 HD 044469; MO1RR000188). The contents of this publication are solely the responsibility of the author and do not necessarily represent the official views of the National Institute of Child Health and Human Development or the National Institutes of Health.

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Authors and Affiliations

  1. Pediatrics/Neonatology, Baylor College of Medicine, Houston, TX, USA

    Chantal Lau

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  1. Chantal Lau
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Correspondence to Chantal Lau .

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Editors and Affiliations

  1. Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA

    Julina Ongkasuwan

  2. Pediatric Gastroenterology and Nutrition, Baylor College of Medicine, Houston, TX, USA

    Eric H. Chiou

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Lau, C. (2018). Maturation of Infant Oral Feeding Skills. In: Ongkasuwan, J., Chiou, E. (eds) Pediatric Dysphagia. Springer, Cham. https://doi.org/10.1007/978-3-319-97025-7_2

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  • DOI: https://doi.org/10.1007/978-3-319-97025-7_2

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