Dysphagia resolution in premature infants

Abstract

Background: Premature infants commonly have difficulty with feeding and swallowing due to neuromuscular immaturity. In some cases, these deficits cause milk to go into the infant’s airway (dysphagia), which poses a threat to infant health and nutrition. Unfortunately, little is known regarding the estimated time to resolution of these deficits. The aim of this investigation is to examine the time to resolution of dysphagia in premature infants. Methods: A retrospective cohort investigation was conducted from a single tertiary hospital examining medical records of premature infants who exhibit penetration or aspiration on videofluoroscopic swallowing assessment (VFSS). Charts were reviewed for follow-up VFSS results pertaining to bolus airway entry, with survival analyses completed to calculate estimated time to resolution of aspiration. Results: Seventy preterm infants were identified and included in this investigation with an average gestational age of 30 ± 5 weeks. The majority of infants (67.1%, N=47) had at least one comorbidity. The vast majority (96%, N=67) underwent a VFSS due to insufficient volume of intake. Infants underwent 1-5 follow-up exams with an average of 3.06 ± 1.15 exams. Half, 50% of the infants achieved aspiration resolution by 5.25 months postmenstrual age (PMA), and 75% achieved resolution by 15 months PMA. Penetration only resolved in 20% (8) of infants by the end of study follow-up time. Interestingly, 41% (N=29) of infants showed a decline in airway protection on at least one consistency during a follow-up exam. Conclusion: Our data suggests the majority of preterm infants with aspiration will have resolution by 15 months PMA, though will continue to have penetration. Future prospective studies controlling for comorbidities and resolution of clinical symptoms are necessary to more clearly define dysphagia resolution timelines.