title: Effect of nasal continuous positive airway pressure on the pharyngeal swallow in neonates.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Division of Pediatric Gastroenterology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: L
authors.identifier: http://orcid.org/0000-0002-3217-676X
authors.initials: L
authors.lastname: Ferrara
authors.affiliation: Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Bronx, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Bidiwala
authors.affiliation: Department of Radiology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: I
authors.initials: I
authors.lastname: Sher
authors.affiliation: Division of Pediatric Pulmonology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Pirzada
authors.affiliation: Department of Radiology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Barlev
authors.affiliation: Department of Biostatistics, Winthrop University Hospital, Mineola, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Islam
authors.affiliation: Department of Pediatrics, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: W
authors.initials: W
authors.lastname: Rosenfeld
authors.affiliation: Hearing and Speech Center, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Crowley
authors.affiliation: Division of Neonatology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: N
authors.initials: N
authors.lastname: Hanna
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000009:adverse effects / Q000379:methods; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D010614:Pharynx / Q000503:physiopathology*; D014481:United States