Abnormal developmental patterns of suck and swallow rhythms during feedingin preterm infants with bronchopulmonary dysplasia

Infants with bronchopulmonary dysplasia (BPD) often have difficulty achievi ng coordinated suckle feeding. To analyze rhythmic differences during feedi ng in infants with BPD we performed weekly studies of 14 infants with BPD ( eight male. six female; postmenstrual age [PMA] 32.1 to 39.7 weeks) and a P MA-matched control group without BPD (n=20), from initiation of bottle feed ing until discharge, with simultaneous digital recordings of pharyngeal and nipple (teat pressure. Unlike the control group, there was no significant correlation between PMA and stability of suckle rhythm, aggregation of suck les or swallows into runs, or length of suckle runs. Comparing those infant s > 35 weeks' PIMA, the group with BPD had significantly decreased stabilit y of suckle rhythm (increased coefficient of variation of suckle-suckle int ervals: 0.34, SE 0.02 vs 0.254, SE 0.014; p=0.003), decreased aggregation i nto suckle runs (71.1, SE 3.4% vs 85.4, SE 2%;p=0.001), and decreased lengt h of suckle runs (7.2, SE 0.9 vs 13.1, SE 1.9 suckles/run; p=0.003), Percen tage of swallows in runs was also decreased in the cohort with BPD (58, SE 3.8% vs 77.2, SE 3.5%; (p <0.001), as was length of swallow run (5.3, SE 0. 5 vs 10.7, SE 1.1; p <0.001). Thus, in infants with BPD, anticipated matura tional patterns of suckle and swallow rhythms did not occur. Delay in attai nment of stable suckle and swallow rhythms in preterm infants, especially a fter 35 weeks' PMA, may predict subsequent feeding and neurological problem s.