Physiological Basis of Neonatal Aerodigestive Difficulties in Chronic Lung Disease

Abstract

In the United States, preterm birth rates have steadily increased since 2014. Despite the recent advances in neonatal-perinatal care, more than 40% of very low-birth-weight infants develop chronic lung disease (CLD) and almost 25% have feeding difficulties resulting in delayed achievement of full oral feeds and longer hospital stay. Establishment of full oral feeds, a major challenge for preterm infants, becomes magnified among those on respiratory support and/or with CLD. The strategies to minimize aerodigestive disorders include supporting nonnutritive sucking, developing infant-directed feeding protocols, sensory oromotor stimulation, and early introduction of oral feeds.

Keywords: Central swallow pattern generator; Chronic lung disease; Noninvasive ventilation; Oral feeding; Oromotor skills; Preterm infants; Respiratory rhythmogenesis; Suck-swallow-breathe coordination.