Swallowing Analyses of Neonates and Infants in Breastfeeding and Bottle-feeding: Impact on Videofluoroscopy Swallow Studies

Abstract

Introduction Dysphagia, when left untreated, can result in an increase in morbidity and mortality rates, especially among infants with history of life-threatening neonatal diseases. The videofluoroscopy swallowing study (VFSS) is considered the gold standard for the diagnosis of dysphagia. There are few imaging studies of infant swallowing based on videofluoroscopy, none of which were performed during breast-feeding. Objective To analyze the similarities and differences in infant swallowing function –regarding the feeding method – breast or bottle – and the impact on videofluoroscopy findings. Methods A retrospective study of 25 VFSSs of breastfeeding and bottle-feeding infants was performed. The studied variables were: oral capture and control; tongue versus mandible movement coordination; sucking pattern; mandible excursion; liquid flow; bolus retention; laryngeal penetration; tracheal aspiration; clearing of material collected in the pharynx; and gastroesophageal reflux (GER). Results The study showed a statistically significant association between nipple/areole capture; oral control; sucking pattern; mandibular excursion; liquid flow and feeding method. The velar sealing deficit, the place that trigger the pharyngeal swallow, food retention in the pharyngeal recesses, laryngeal penetration and GER were also factors associated with the feeding method. Conclusion The analysis of the swallowing characteristics of both feeding methods revealed significant differences between them, with an impact on the diagnosis in the VFSSs, especially regarding velar function.

Quantitative imaging of tongue kinematics during infant feeding and adult swallowing reveals highly conserved patterns

“…These studies highlight the disadvantages of bottle‐feeding, especially the problem of nipple confusion: changes in feeding behavior that make breastfeeding more difficult after exposure to bottles (Batista et al, 2019; Mizuno & Ueda, 2006; Moral et al, 2010; Praborini et al, 2016). However, the observations are based on subjective descriptions of the tongue and orofacial muscles, specifically using visual analysis of videofluoroscopy swallow (Hernandez & Bianchini, 2019), EMG measurement of facial muscles (França et al, 2014), recording of swallowing sounds (Tamura et al, 1996), and rates of sucking and breathing (Taki et al, 2010). The present analysis of ultrasound video clips elucidates the dynamic pattern of the infant's tongue during feeding.…”

“…Many infants are also fed with man-made bottles and nipples, whether with human milk extracted by hand or a breast pump, or with modified animal milks or plant protein solutions. Though the dynamic performance of the infant during bottle-feeding seems to be similar to that of breastfeeding (Smith et al, 1985) there are significant differences (Hernandez & Bianchini, 2019). Artificial nipples are more rigid than human nipples and do not reshape themselves to fit the infants' mouth in response to the feeding action (Goldfield et al, 2006).…”

Analysis of Clinical Efficacy of Traditional Chinese Medicine in Recovery Stage of Stroke: A Systematic Review and Meta-Analysis

“…The videofluoroscopy swallow study (VFSS) is considered the gold standard for the detection of swallowing dysfunction [ 107 ]. The higher the score, the better the swallowing function.…”

Flexible Endoscopic Evaluation of Swallowing in Breastfeeding Infants With Laryngomalacia: Observed Clinical and Endoscopic Changes With Alteration of Infant Positioning at the Breast

“…10 However, using a bottle in a VFSS to assess an exclusively breastfeeding infant's swallow is of questionable validity, given increasing evidence of differences between the biomechanics of sucking when comparing breastfeeding and bottle feeding. [11][12][13] Because of practical challenges in imaging or viewing the breastfeeding swallow, there is still very little known regarding the differences in the pharyngeal phase of swallowing between breastfeeding and bottle feeding. There are only 2 published cine radiographic studies (VFSS or historic equivalent) of breastfeeding that describe suck-swallow dynamics.…”