Deprivation and dysphagia in premature infants.

The developmental trajectory of feeding features increasingly rhythmic ingestive behavior patterns. Sucking and swallowing by the fetus and infant, including fetal consumption of amniotic fluid, depend upon brainstem central pattern generators whose activity is increasingly influenced by chemosensory and oral-tactile input. This neurobiological fact underlies the clinical discovery that oral-tactile stimulation via pacifier stimulates ingestive behavior in tube-fed, premature infants and improves their feeding skills. However, little is known regarding the degree to which oral sensory deprivation may contribute to feeding problems in these patients. Evidence of deprivation-induced neuropathologic effects in rodents further underlines the potential impact of sensory deprivation in premature newborns, whose transition period from tube to oral feeding often lasts weeks beyond term equivalent gestational age. Studies exploring the link between early dysphagia and later developmental impairment could clarify experiential antecedents of cerebral injury. Trials of sensory interventions to promote feeding development are warranted.