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. 2024 Mar;59(3):600-608.
doi: 10.1002/ppul.26788. Epub 2023 Dec 1.

Breastfeeding in infants who aspirate may increase risk of pulmonary inflammation

Daniel R Duncan  1 , Clare Golden  1 , Kara Larson  1 , Nina Williams  1 , Tregony Simoneau  2 , Rachel L Rosen  1
Affiliations

Breastfeeding in infants who aspirate may increase risk of pulmonary inflammation

Daniel R Duncan et al. Pediatr Pulmonol. 2024 Mar.

Abstract

Objective: To evaluate management strategies and pulmonary outcomes for breastfed infants with oropharyngeal dysphagia.

Study design: We performed a retrospective cohort study of breastfed infants diagnosed with oropharyngeal dysphagia with documented aspiration or laryngeal penetration on videofluoroscopic swallow study (VFSS). Medical records were reviewed for VFSS results and speech-language pathologist recommendations following VFSS, results of chest x-ray, results of bronchoalveolar lavage (BAL) within 1 year of VFSS, and aspiration-related hospitalizations occurring before or within 1 year of VFSS. Subjects were categorized as cleared or not cleared to breastfeed based on the VFSS. Proportions were compared with Chi-square and Fisher's exact tests and means with Student's t-tests.

Results: Seventy-six infants (4.7 ± 0.4 months old) were included; 50% (38) had aspiration and 50% (38) had laryngeal penetration. After VFSS, 70% (53) were cleared to breastfeed while 30% (23) were not cleared to breastfeed. Patients with aspiration were less likely to be cleared to breastfeed (p = .006); however, 55% (21/38) of those with aspiration were still cleared to breastfeed. Infants cleared to breastfeed had significantly more pulmonary hospitalizations (p = .04) and were also at increased risk of elevated neutrophil count (p = .02) and culture growth on BAL (p = .01). Significantly increased abnormal neutrophil count was also found in those cleared to breastfeed with laryngeal penetration (p = .01).

Conclusions: Infants with oropharyngeal dysphagia counseled to continue breastfeeding had increased risk of BAL inflammation and more pulmonary hospitalizations compared to those that were told to stop breastfeeding.

Keywords: aspiration; breastmilk; laryngeal penetration; videofluoroscopic swallow study.

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Conflict of interest statement

Conflict of Interest Disclosures:

The authors have no conflicts of interest relevant to this article to disclose.

References

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