Safety in infant oral feeding implies minimal risk of aspiration and requires the adequate coordination of sucking, swallowing and respiration as the anatomical pathways for air and nutrients share the same pharyngeal tract. In addition to their individual rhythmic functionality, these three functions need to occur sequentially from the oral to pharyngeal to pulmonary phases.
Swallow needs to occur during a safe phase of the respiratory cycle. Therefore, to assist in our understanding of the coordination of these three functions, it becomes advantageous to incorporate the concept of cross-systems interactions with that of CPGs. These studies support our working premise that mechanical maturation of oral feeding skills need to occur at the peripheral and central levels, i.e. muscles and central nervous system.
As these maturational processes cannot be measured directly, we monitored changes over time of specific oral feeding skills that reflected their performance when preterm infants transitioned from tube to oral feeding.
Developmental processes of suck, swallow and respiration would be, first, reflected by maturation indices of specific oral feeding skills at different times and/or rates and, second, dependent upon gestational and postmenstrual ages (PMA).
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