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  • Original Article
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Effect of nasal continuous positive airway pressure on the pharyngeal swallow in neonates

Journal of Perinatology volume 37, pages 398–403 (2017)Cite this article

Subjects

Abstract

Objective:

Feeding neonates orally while on nasal continuous positive airway pressure (nCPAP) is a common practice. We hypothesize that pressurized airflow provided by nCPAP will alter the swallowing mechanism in neonates, increasing the risk of aspiration during oral feeding.

Study Design:

Infants receiving nCPAP with a RAM cannula and tolerating at least 50% of their feeding orally were included in the study (one term; six preterm infants). Each participant underwent a videofluoroscopic swallow study while on nCPAP and off nCPAP. A non-parametric signed-rank test was used for paired data.

Result:

The incidence of deep penetration (P=0.03) and aspiration (P=0.01) decreased significantly off-nCPAP compared with on-nCPAP. However, the incidence of mild penetration (P=0.65) and nasopharyngeal reflux (P=0.87) remained the same under both conditions.

Conclusion:

Oral feeding while on-nCPAP significantly increases the risk of laryngeal penetration and tracheal aspiration events. We recommend caution when initiating oral feedings on nCPAP.

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Acknowledgements

We extend our sincere appreciation to all Winthrop NICU nurses who assisted in conducting the study.

Author information

Author notes

  1. L Ferrara and A Bidiwala: These authors contributed equally to this work.

Authors and Affiliations

  1. Division of Pediatric Gastroenterology, Children’s Medical Center at Winthrop University Hospital, Mineola, NY, USA

    L Ferrara

  2. Division of Respiratory and Sleep Medicine, Children’s Hospital at Montefiore, Bronx, NY, USA

    A Bidiwala

  3. Department of Radiology, Children’s Medical Center at Winthrop University Hospital, Mineola, NY, USA

    I Sher & D Barlev

  4. Division of Pediatric Pulmonology, Children’s Medical Center at Winthrop University Hospital, Mineola, NY, USA

    M Pirzada

  5. Department of Biostatistics, Winthrop University Hospital, Mineola, NY, USA

    S Islam

  6. Department of Pediatrics, Children’s Medical Center at Winthrop University Hospital, Mineola, NY, USA

    W Rosenfeld

  7. Hearing and Speech Center, Long Island Jewish Medical Center, New Hyde Park, NY, USA

    C C Crowley

  8. Division of Neonatology, Children’s Medical Center at Winthrop University Hospital, Mineola, NY, USA

    N Hanna

Authors
  1. L Ferrara
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  2. A Bidiwala
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  3. I Sher
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  4. M Pirzada
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  6. S Islam
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Corresponding author

Correspondence to N Hanna.

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The authors declare no conflict of interest.

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Ferrara, L., Bidiwala, A., Sher, I. et al. Effect of nasal continuous positive airway pressure on the pharyngeal swallow in neonates. J Perinatol 37, 398–403 (2017). https://doi.org/10.1038/jp.2016.229

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  • DOI: https://doi.org/10.1038/jp.2016.229

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