Swallow Safety is Determined by Bolus Volume During Infant Feeding in an Animal Model.
Christopher J Mayerl, Alexis M Myrla, Francois D H Gould and 3 others
PMID 32328794WHAT IT FOUND
Larger bolus size was the primary predictor of unsafe swallows in infant pigs.
Term infants swallowed larger volumes and experienced more penetration and aspiration than preterm infants, regardless of nerve damage.
Key findings
01Bolus area was the primary predictor of penetration or aspiration, with larger volumes significantly increasing risk.
02Term infant pigs were more likely to experience penetration and aspiration than preterm pigs because they swallowed larger boluses.
03Recurrent laryngeal nerve lesion did not consistently affect the likelihood of penetration or aspiration.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was conducted in infant pigs, not humans, so direct application to human infants is limited. Bolus size was measured as a two-dimensional area rather than total volume. The study did not identify the specific physiological mechanisms of airway protection failure. The sample size was small (18 animals).
Declared interests
The authors declare no competing interests.
The easy way to misread this
Do not assume that nerve damage is the primary cause of aspiration in infants. This study found that bolus size, not nerve lesion, was the main predictor of unsafe swallows. Clinicians should evaluate bolus volume as a critical factor in feeding safety.