Published online September 24, 2007
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e1035-e1042 (doi:10.1542/peds.2006-3567)
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ARTICLE

Infants With Bronchopulmonary Dysplasia Suckle With Weak Pressures to Maintain Breathing During Feeding

Katsumi Mizuno, MD, PhD, Yoshiko Nishida, MD, Motohiro Taki, MD, Satoshi Hibino, MD, Masahiko Murase, MD, Motoichirou Sakurai, MD, PhD and Kazuo Itabashi, MD, PhD

Department of Pediatrics, Showa University of Medicine, Tokyo, Japan

OBJECTIVE. Preterm infants with bronchopulmonary dysplasia often demonstrate sucking difficulties. The aim of this study was to determine whether the severity of bronchopulmonary dysplasia affects not only coordination among suck–swallow–respiration but also sucking endurance and performance itself.

PATIENTS AND METHODS. Twenty very low birth weight infants were studied. Infants with anomalies or intraventricular hemorrhage were excluded from the evaluation. Subjects were divided into 3 groups: no bronchopulmonary dysplasia (7 infants), bronchopulmonary dysplasia without home oxygen therapy (7 infants), and bronchopulmonary dysplasia with home oxygen therapy (6 infants). In addition to sucking efficiency, pressure, frequency, duration, and duration of sucking burst, length of deglutition apnea, number of swallows per burst, and respiratory rate were also measured during bottle-feeding at 40 weeks' postmenstrual age. In addition, PCO2 and oxygen saturation were measured at rest and during bottle-feeding.

RESULTS. Infants with severe bronchopulmonary dysplasia demonstrated not only the lowest sucking pressure and sucking frequency, shortest sucking burst duration, and lowest feeding efficiency but also the lowest frequency of swallows during the run and the longest deglutition apnea. The respiratory rate was highest, and the decrease in oxygen saturation was largest, in infants with severe bronchopulmonary dysplasia.

CONCLUSIONS. Feeding problems depend on the severity of bronchopulmonary dysplasia. Infants with bronchopulmonary dysplasia demonstrated not only poor feeding coordination but also poor feeding endurance and performance.

Key Words: bronchopulmonary dysplasia • home oxygen therapy • sucking • swallowing • very low birth weight infant

Abbreviations: BPD—bronchopulmonary dysplasia • PMA—postmenstrual age • HOT—home oxygen therapy

Accepted Mar 14, 2007.