Coordination of sucking, swallowing, and breathing in healthy full-term and near-term infants

Successful feeding requires precise coordination of sucking, swallowing, and breathing. We aimed to describe the normal organization of bottle feeding in healthy newborn infants (10 full-term and 3 near-term). Sucking pressure and breathing movements were recorded by specialized pressure transducers. Swallowing sounds were recorded on a professional DAT sound recorder with a miniature microphone attached to the infant's throat. A well-coordinated feeding pattern showed flexibility and good control, and was characterized by a 1:1:1 coordination of sucking, swallowing, and breathing, where maximum sucking pressure was coordinated with breathing out, and swallowing took place just before the onset of the next suck and between breathing out and breathing in. An efficient sucking pattern was characterised by a relatively lower sucking pressure and longer duration of each suck. When the coordination broke down, breathing was typically the bottleneck, with infants being unable to maintain adequate ventilation while sucking and swallowing during nutritive feeding. In order to be able to positively identify abnormal feeding patterns that may be indicative of brain damage in infants who are neurologically at risk, detailed knowledge about what characterizes a normal feeding pattern is first required. The results of this study are promising as they provide us with norm data on the temporal organization between sucking, swallowing, and breathing. However, in order to be able to use feeding successfully to identify neurological problems in infants early on in life, more data on premature infants are warranted.