title: Neonatal swallowing assessment and practical recommendations for oral feeding in a girl with a severe congenital myopathy.
abstract: The investigators report the case of a 6-week-old girl with a cap-like congenital myopathy and frequent coughing during feeding. Neonatal swallowing assessments were performed with surface electromyography of the submental muscle group and nasal airflow during sucking and swallowing. A videofluoroscopic swallow study was performed separately. The registration of swallowing and breathing revealed a highly coordinated sequence of sucking, swallowing, and breathing. However, after a series of sucking and swallowing there was residue in the hypopharyngeal area, causing laryngeal penetration and coughing. Based on the findings, specific recommendations such as the use of a soft nipple, diminished suck-swallow sequences, and limited feeding time were made for this girl. These proved to be appropriate to prevent coughing as a signal of penetration or aspiration of milk during swallowing. This case highlights the profit of neonatal swallowing assessment, which can provide recommendations for safe oral feeding.
authors.affiliation: Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, The Netherlands. L.vandenEngel@reval.umcn.nl
authors.forename: Lenie
authors.initials: L
authors.lastname: van den Engel-Hoek
authors.forename: Corrie E
authors.initials: CE
authors.lastname: Erasmus
authors.forename: Bert J M
authors.initials: BJ
authors.lastname: de Swart
authors.forename: Lilian T L
authors.initials: LT
authors.lastname: Sie
authors.forename: Imelda J M
authors.initials: IJ
authors.lastname: de Groot
mesh_terms: D003371:Cough / Q000209:etiology; D003679:Deglutition; D004576:Electromyography; D005248:Feeding Methods / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007223:Infant; D009135:Muscular Diseases / Q000150:complications / Q000151:congenital*; D017410:Practice Guidelines as Topic; D013391:Sucking Behavior