The Development of Normal Feeding and Swallowing

doi:10.1016/S0031-3955(16)38229-3

Pediatric Clinics of North America

Volume 38, Issue 6, December 1991, Pages 1439-1453

https://doi.org/10.1016/S0031-3955(16)38229-3 Get rights and content

The development of feeding in infants and young children is a complex physiologic task. This complexity is compounded by the influence of growth, neurologic maturation, learning, social interaction, and other factors. An understanding of the process enables the primary care physician to provide sound guidance to parents and establishes a framework for managing complex feeding problems.

REFERENCES (22)

R.S. Illingworth et al.
The critical or sensitive period, with special reference to certain feeding problems in infants and children
J Pediatr
(1964)
R. Alexander
Prespeech and feeding
J.F. Bosma
Development of feeding
Clinical Nutrition
(1986)
J.F. Bosma
Postnatal ontogeny of performances of the pharynx, larynx, and mouth
Am Rev Respir Dis
(1985)
D.W. Buchholz et al.
Adaptation, compensation, and decompensation of the pharyngeal swallow
Gastrointest Radiol
(1985)
S. Cosminsky
Infant feeding practices in rural Kenya
W.S. Crysdale
Management options for the drooling patient
Ear, Nose and Throat
(1989)
W.J. Dodds et al.
Physiology and radiology of the normal oral and pharyngeal phases of swallowing
AJR Am J Roentgenol
(1990)
M.W. Donner et al.
Anatomy and physiology of the pharynx
Gastrointest Radiol
(1985)
C.A. Fox
Implementing the modified barium swallow evaluation in children who have multiple disabilities
Infants and Young Children
(1990)

E.G. Gisel

Effect of food texture on the development of chewing of children between six months and two years of age

Dev Med Child Neurol

(1991)

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Swallowing is one of the key processes required for life. It is an essential everyday process and largely continues without any complications in most people, requiring the involvement of both voluntary and involuntary muscles of the upper gastrointestinal tract that contract in a fashion that allows breathing to continue without disruption. As the anatomic pathway has dual functionality, the risks of aspiration are high and may lead to complications such as pneumonia. Oropharyngeal dysphagia usually occurs when there is a problem with the anatomy, physiology, or neurophysiology of any of these structures and is most commonly related to chronic neurologic conditions, particularly Parkinson’s disease, stroke, and dementia; it is not considered part of normal aging (see sections on causation below). The options for investigation and treatment of oropharyngeal dysphagia are also discussed and remain tailored to the patients' disease and presentation.
Pathophysiology of aspiration in a unilateral SLN lesion model using quantitative analysis of VFSS
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Citation Excerpt :
All control and the majority of uSLN piglets aspirated prior to LVC. Incidence of aspiration in control piglets is not surprising given that aspiration has previously been found to be common in intact human and animal infants,[48-53] and may indicate the iSLN and sensory branch of the RLN may not be completely developed or sensitive to aspiration during early infancy. Although most human infants exhibit swallowing by 15 weeks gestation, the swallow trigger in a fluid-filled environment is likely governed by central pattern generators rather than a discrete bolus [54].
The purpose of this study was to elucidate the pathophysiology of aspiration in previously studied female infant piglets after a unilateral superior laryngeal nerve (uSLN) lesion.
Videofluoroscopic swallow studies (VFSS) were acquired from 15 female piglets ages 2–3 weeks (9 with uSLN lesion and 6 controls). VFSS were analyzed at 30 frames/second sampling rate. Quantitative measures were conducted and compared between groups using published methodologies for VFSS assessment in adult and infant humans. Measures included the: 1) number of lingual-palatal contacts (LPC) (i.e. pre-swallow), 2) total pharyngeal transit time (TPT), 3) offset of swallow (offP), as well as onset of: 4) pharyngeal stage (onP), 5) pharyngoesophageal segment opening (oPES), 6) maximum PES opening (maxPES), 7) airway closure onset (oAC), and 8) maximum airway closure (maxAC). Measures 5–7 were determined relative to onP. Bolus residue was rated by severity (0 (none) to 3 (severe)). A gamma regression was used to compare continuous measures between lesioned and control groups.
The number of LPC (p = .006), TPT (p = .023) and timing of maxAC (p = .041) were significantly greater in the uSLN lesion than the control group.
Outcomes of this study replicated prior published findings and elucidated that piglets with right uSLN lesions exhibited delayed maxAC. Noteworthy was the use of clinically relevant quantitative videofluoroscopic measures in piglets for comparison to future studies in human pediatric populations.
Factors associated with masticatory performance and swallowing threshold according to dental formula development
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The aims of the present study were to the determine changes in, and factors related to, masticatory performance and swallowing threshold according to dental formula development.
A total of 120 subjects, ranging in age from 4 to 19, and 21 to 29 years, were included in the present study. Grip strength and maximum occlusal force were measured in all subjects. Masticatory performance and swallowing threshold (including the number of chewing cycles and chewing time), were determined according to the concentration of dissolved glucose obtained from gummy jellies. The 12-item General Health Questionnaire (GHQ-12) was used to assess mental health status in participants 21 to 29 years of age.
In the primary dentition, masticatory performance and glucose concentration before swallowing were the lowest in all dentition groups. Masticatory performance was the highest in subjects 21–29 years of age. In children with mixed and permanent dentition, glucose concentration levels before swallowing were similar to those in individuals aged 21–29 years. Multiple regression analysis revealed that maximum occlusal force was significantly and positively correlated with glucose concentration before swallowing in children, and the GHQ-12 score was significantly and negatively correlated with glucose concentration before swallowing in young adults.
Changes in swallowing threshold did not coincide with masticatory performance according to dental formula stage. Maximum occlusal force was the variable most strongly associated with swallowing threshold in children, while in young adults, better mental health status was closely associated with a higher swallowing threshold.
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: Address reprint requests to: Richard D. Stevenson, MD, Department of Pediatrics, Kluge Children’s Rehabilitation Center, University of Virginia, 2270 Ivy Rd., Charlottesville, VA 22901

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The Development of Normal Feeding and Swallowing

J Pediatr

Prespeech and feeding

Development of feeding

Clinical Nutrition

Postnatal ontogeny of performances of the pharynx, larynx, and mouth

Am Rev Respir Dis

Adaptation, compensation, and decompensation of the pharyngeal swallow

Gastrointest Radiol

Infant feeding practices in rural Kenya

Management options for the drooling patient

Ear, Nose and Throat

Physiology and radiology of the normal oral and pharyngeal phases of swallowing

AJR Am J Roentgenol

Anatomy and physiology of the pharynx

Gastrointest Radiol

Implementing the modified barium swallow evaluation in children who have multiple disabilities

Infants and Young Children

Effect of food texture on the development of chewing of children between six months and two years of age

Dev Med Child Neurol