Advances with Neonatal Aerodigestive Science in the Pursuit of Safe Swallowing in Infants: Invited Review.
Sudarshan R Jadcherla
PMID 28044203WHAT IT FOUND
Infant feeding problems involve immature swallowing, airway protection and reflux.
In the authors' own experience, 51% of 100 infants referred for long-term gastrostomy avoided tube placement at discharge, and 84% fed orally by 1 year. This is reported experience, not tested evidence.
Key findings
01The review describes neonatal feeding difficulty as involving developing central and enteric nervous system, airway and pulmonary systems, and oropharyngeal-esophageal systems, with aspiration during feeding or reflux.
02In 100 infants referred for long-term gastrostomy feeding strategies, the authors report gastrostomy was avoided at discharge in 51%, and 84% achieved independent oral feeding by 1 year.
03In their standardized feeding program, over 81% reached full enteral feeds and 72% reached full oral feeds sooner, with lower length of stay and gastrostomy rates than baseline.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review and authors' service experience, not a controlled clinical trial. The outcome reports do not describe how infants were selected, how outcomes were measured, or how the later period was compared with the baseline period. The favorable gastrostomy and oral feeding rates are from the authors' own program, so they may reflect natural maturation, selection or other concurrent NICU care. The paper does not state whether clinicians assessing outcomes were blinded to the feeding approach. The population is high-risk neonates referred for feeding problems, so the results may not apply to all infants with feeding difficulty.
Declared interests
The supplied metadata lists NIH extramural research support. The text does not include a conflict-of-interest or funding declaration.
The easy way to misread this
Do not read the reported gastrostomy avoidance and oral feeding rates as proof that the feeding program works. They come from the authors' own service experience, without a concurrent control group or detailed methods, so they cannot separate the program's effect from natural maturation or other concurrent care.