Special Topic Course 30: Normal Swallowing in Healthy Term Infants: Are Signs of Aspiration a Normal Variant?
Speakers: Katlyn McGrattan, PhD, CCC-SLP & Morgan Zoeller, MA, CF-SLP
Topic: Normal Swallowing in Healthy Term Infants: Are Signs of Aspiration a Normal Variant?
Background: Feeding therapists regularly evaluate infants for signs of aspiration during feeds (1,7). When such events are detected, interventions to mitigate these occurrences are applied (1,2-6). Interestingly, it is widely accepted within the adult literature that occasional instances of aspiration are a normal variant of function that pose no deleterious pulmonary effects in healthy individuals (8). However, little is known regarding these normal correlates of aspiration in infants (9). The aim of this investigation is to fill this void by establishing objective normal correlates of feeding performance among healthy, non-dysphagic infants.
Methods: Healthy full-term infants without concerns for swallowing impairments were prospectively enrolled for home monitoring of their feeding performance. Monitoring was completed 48 hours each week throughout the first month of life and included feeding times, volume of intake, and number of feeding-related coughing episodes. Data was summarized using descriptive statistics, with changes in coughing throughout the first month of life evaluated using a paired t-test.
Results: Nineteen infants (53% female) were enrolled in the investigation at the time of abstract submission. The majority of infants (68%) coughed at least once each monitoring period, with the number of feeding related coughing episodes ranging from 0-35 times per two-day data collection period. This equated to infant’s coughing during an average of 15% of their feeds. No significant changes in the proportion of feeds with coughs were observed throughout the first month of life (p=0.13).
Conclusions: Some coughing during feeds is likely a normal variant of development among healthy term infants.
Katlyn McGrattan, PhD, CCC-SLP is an Assistant Professor in the Department of Speech-Language-Hearing Science at the University of Minnesota and a Speech Pathologist at Masonic Children’s Hospital. She completed doctoral training in Health & Rehabilitation Science at the Medical University of South Carolina, and post-doctoral training in Neonatal Gastroenterology at Nationwide Children’s Hospital. Her research focuses on the use of refined physiologic assessment to identify impairments in neonatal upper aerodigestive physiology and apply targeted therapeutic interventions to maximize treatment effect.
Morgan Zoeller, MA, CF-SL is a graduate of the University of Minnesota where she earned her master’s degree in Speech-Language Pathology. She received her bachelor’s degree in Speech-Language-Hearing Sciences from Northern Michigan University. During her graduate career she was a graduate student assistant for the University of Minnesota lab: Consortium for Pediatric Aerodigestive Advancement (CPAA) directed by Dr. Katlyn E. McGrattan. In addition, she completed clinical placements across the lifespan including pediatric acute care as well as skilled nursing facilities. Currently, she is a clinical fellow in Speech-Language Pathology working in the medical setting in both acute care and inpatient rehabilitation.
0:00-5:00 min: Introduction to topic and course outline
5:00-25:00 min: Importance of elucidating normal infant swallowing attributes
25:00-40:00 min: Normal adult swallowing and aspiration implications
40:00-60:00 min: Case Studies: Feeding characteristics in healthy non-dysphagic infants
60:00-63:00 min: Learning assessment
Katlyn McGrattan, PhD, CCC-SLP
Financial Disclosures: Speaker receives a salary from the University of Minnesota and the Masonic Children’s Hospital. Presenter is a consultant for Biogen and Avexis and receives a grant from Biogen for SMA 1 investigation. Presenter has ownership in nuBorn Medical and Science Stand.
Nonfinancial Disclosures: No relevant disclosures
Morgan Zoeller, MA, CF-SLP
Financial Disclosures: No relevant disclosures
Nonfinancial Disclosures: No relevant disclosures
Conflict of Interest: There is no conflict of interest for anyone with the ability to control content for this activity.
Target Audience: OT, SLP, PT, and neonatal professionals
Educational Level: Intermediate
- Identify the percent of infants who cough during breast and bottle feeds.
- Identify the range of coughing episodes that can be observed during feeds in healthy normal infants.
- List how the proportion of feeds with a cough change throughout the first month of life.
Instructional Methods: Recorded webinar, lecture, and case studies. Learning assessment and course evaluation follow course.
Course Completion Requirements:
The learner must view the entire webinar, complete the course evaluation and complete the post webinar learning assessment with at least 80% to receive education credit. Login and logout times will be recorded and documented.
Following completion of this course physical therapists, nurses and other disciplines will receive a certificate of completion and a zip file containing information necessary to submit to their individual state for education credit. Zip file will include course bibliography. Physical therapists are responsible for knowing and adhering to their state’s deadlines, rules and regulations.
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