Abstract
Background
The formation of a bolus of food is critical for proper feeding function, and there is substantial variation in the size and shape of a bolus prior to a swallow. Preterm infants exhibit decreased abilities to acquire and process food, but how that relates to their bolus size and shape is unknown. Here, we test two hypotheses: (1) that bolus size and shape will differ between term and preterm infants, and (2) bolus size and shape will change longitudinally through development in both term and preterm infants.
Methods
To test these hypotheses, we measured bolus size and shape in preterm and term infant pigs longitudinally through nursing using high-speed videofluoroscopy.
Results
Preterm infant pigs swallowed smaller volumes of milk. Although term infants increased the amount of milk per swallow as they aged, preterm infants did not. These changes in bolus volume were also correlated with changes in bolus shape; larger boluses became more elongate as they better filled the available anatomical space of the valleculae.
Conclusions
These results suggest that preterm birth reduces the ability of preterm pigs to increase bolus size as they grow, affecting development in this fragile population. These results highlight that studies on term infant feeding may not translate to preterm infants.
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Acknowledgements
We would like to thank K. Wu, E. Catchpole, C. Lewis, J. Irizarry, and K. McGrattan for their assistance caring for piglets and collecting data, as well as S. Dannemiller for his expertize in delivering and caring for the piglets. This project was funded by NIH R01 HD088561 to R.Z.G.
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Study design: C.J.M., R.Z.G, and F.D.H.G. Performed data collection: C.J.M., L.E.B., B.M.S., R.Z.G, and F.D.H.G. Processed data: C.J.M. and A.M.M. Analyzed data: C.J.M and F.D.H.G. Wrote manuscript: C.J.M. Provided comments on manuscript: all authors.
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Animal care and procedures were approved by NEOMED Institutional Animal Care and use Committee (#17-04-071).
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Mayerl, C.J., Myrla, A.M., Bond, L.E. et al. Premature birth impacts bolus size and shape through nursing in infant pigs. Pediatr Res 87, 656–661 (2020). https://doi.org/10.1038/s41390-019-0624-0
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DOI: https://doi.org/10.1038/s41390-019-0624-0
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