Aspiration and Dysphagia in the Neonatal Patient

Schrepfer, Thomas; Hartnick, Christopher J.

doi:10.1016/j.clp.2018.07.005

Cited by 26 publications

(36 citation statements)

References 70 publications

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“…As perinatal survival outcomes for premature and otherwise vulnerable neonates have improved with technological advances, a greater number of neonates are surviving with significant feeding difficulties [ 17 ]. To establish effective feeding is a prerequisite for the survival of neonates and infants.…”

Section: Discussionmentioning

confidence: 99%

Association between Swallowing-Related Questionnaire Responses and Pathological Signs on Videofluoroscopy in Children

et al. 2021

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The aim of this study was to identify relationships in children between responses to specific questions of interest in a clinical questionnaire concerning swallowing-related difficulties and pathological signs on a videofluoroscopic swallowing study (VFSS). A prospective data analysis was made of children evaluated with swallowing disorder between January 2018 and April 2021 at a tertiary care centre. Each child enrolled in the study underwent a subjective evaluation (targeted questions) and instrumental examination (VFSS). In total, 51 children suffering from swallowing problems (32 with a neurological disorder and 19 without neurological disorder) were included into the study. Our results showed there was a correlation between the occurrence of specific symptoms (wet voice, wet breathing, recurrent respiratory infections, chronic mucus) and other pathological signs on a VFSS (laryngeal penetration, residua, nasal regurgitation). The evaluation of these specific questions is a reliable and useful method for the management of dysphagia in neonates and infants. It can help us in selecting those patients for which it is appropriate to perform a VFSS.

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Section: Discussionmentioning

confidence: 99%

Association between Swallowing-Related Questionnaire Responses and Pathological Signs on Videofluoroscopy in Children

et al. 2021

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“…In our study, two term infants and one early preterm infant with prolonged swallowing dysfunction were confirmed to have cerebral palsy. Frequent aspiration and dysphagia in neonatal period can be a predictor of neurodevelopmental delay, and infants with developmental delay usually have prolonged aspiration or feeding problems in International Journal of Pediatrics neonatal period, vice versa [20]. So, we need to check infants with prolonged feeding problems whether there are neurologic complications.…”

Section: Discussionmentioning

confidence: 99%

Development of Swallowing Function in Infants with Oral Feeding Difficulties

Han

Shin

Jeon

2020

International Journal of Pediatrics

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Background. Discharge of preterm infants is often delayed because of their oral feeding difficulties. Independent oral feeding is the last obstacle to pass after managing acute and chronic morbidities. We conducted this study to determine the prevalence, characteristics, and risk factors of swallowing dysfunction and suggest proper interventions to reduce aspiration and chronic lung injury. Methods. Infants admitted to the neonatal intensive care unit (January 2016 to December 2018) who were performed modified barium swallow study due to oral feeding difficulties were enrolled. Modified barium swallow study was done≥postmenstrual age 37 weeks to limit radiation exposure. Clinical data were collected retrospectively. Swallowing dysfunction was defined as inadequate epiglottic closure, laryngeal penetration, or tracheal aspiration according to result of the modified barium swallow study. Results. Among a total of 54 infants enrolled, nine (16.7%) were term infants, 13 (24.1%) were late preterm infants (gestational age, 34-36 weeks), and 32 (59.3%) were early preterm infants (gestational age<34 weeks). Gestational age and birth weight were smaller in infants with swallowing dysfunction. Total duration of mechanical ventilation and duration of invasive ventilation were longer in infants with swallowing dysfunction. The risk of swallowing dysfunction increased by 11.2 times for infants with gestational age<29 weeks compared to infants with gestational age≥29 weeks. Swallowing dysfunction was improved in most infants after they became matured. They showed different time and rate of maturation with the help of rehabilitation through swallow therapy and dietary modification with thickened formula. Conclusion. Preterm infants with gestational age<29 weeks or with longer ventilation duration are at a higher risk of aspiration. Rehabilitation of swallow therapy and dietary modification with thickened formula can be helpful interventions to prevent aspiration and chronic lung injury and reassure parents until independent oral feeding is possible.

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“…Participants with OPD showed poor reflexes and inappropriate oral structures for feeding. Infants with neurological conditions are likely to experience OPD because of impaired neural control required for the oral musculature and the coordination of sucking, swallowing, and breathing (Raol, Schrepfer, & Hartnick, 2018; Slattery, Morgan, & Douglas, 2012).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and associated prenatal and perinatal risk factors for oropharyngeal dysphagia in high-risk neonates in a South African hospital

Costa

Krüger

Kritzinger

et al. 2019

South African Journal of Communication Disorders

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BackgroundThe prevalence of neonatal oropharyngeal dysphagia (OPD) in high-risk infants in lower-middle-income countries is unknown.ObjectivesTo determine the prevalence and associated risks for OPD in high-risk neonates in order to allow timely intervention for OPD, minimising negative outcomes.MethodA prospective cross-sectional observational study was conducted in an urban hospital in South Africa. Clinical feeding assessments were conducted using the Neonatal Feeding Assessment Scale with all available neonates in neonatal care.ResultsThe sample of 81 high-risk neonates (mean chronological age = 11.7 days; standard deviation = 15.6 days) had been feeding orally for 2 days and were approaching discharge. Fifty-two participants (64.2%) had OPD. Risks likely associated with OPD included breech presentation, septicaemia and other infections, spending more than 1 day on a warm table or incubator, neurological conditions, prenatal exposure to maternal smoking, siblings with mental or neurological disability, participants with congenital disorders, preterm birth (< 37 weeks), low birth weight (< 2500 g), or retinopathy of prematurity.ConclusionAn unexpected high prevalence of OPD was found in neonates already deemed ready for oral feeding and approaching discharge. Timely early involvement of the Speech-Language Therapists (SLTs) in decision-making about feeding readiness may prevent serious complications of neonatal OPD. Findings may inform South African neonatal clinicians. The study provides motivation for early intervention from SLTs before the infant and mother are discharged from high care and dispersed to communities where intervention services may be scarce.

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Aspiration and Dysphagia in the Neonatal Patient

Cited by 26 publications

References 70 publications

Association between Swallowing-Related Questionnaire Responses and Pathological Signs on Videofluoroscopy in Children

Association between Swallowing-Related Questionnaire Responses and Pathological Signs on Videofluoroscopy in Children

Development of Swallowing Function in Infants with Oral Feeding Difficulties

Prevalence and associated prenatal and perinatal risk factors for oropharyngeal dysphagia in high-risk neonates in a South African hospital

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