Nutritive and non-nutritive swallowing apnea duration in term infants: implications for neural control mechanisms.

The impact of bolus ingestion and level of consciousness on swallowing apnea duration (SAD) in healthy term infants has not been adequately explored despite the likely contribution of swallowing apnea to upper airway protection against aspiration. SAD during wakefulness, sleep, and feeding (breast or bottle) of 10 term infants was measured 10 times from birth to 1 year of age. Nineteen thousand four hundred and two swallows were analyzed. Irrespective of age, SAD during feeding was significantly shorter than SAD of non-nutritive swallowing (during wakefulness and sleep). SAD did not change significantly within the first year of life in any of the three conditions and there was no change in the relative durations of nutritive, wake and sleep conditions with age. The absence of an age effect implies that the neural mechanisms controlling SAD are fundamentally brainstem-mediated and largely hard-wired at birth in healthy term neonates.