Coordination of sucking, swallowing and breathing in the newborn: its relationship to infant feeding and normal development.

Non-invasive, sensitive equipment was designed to record nasal air flow, the timing and volume of milk flow, intraoral pressure and swallowing in normal full-term newborn babies artificially fed under strictly controlled conditions. Synchronous recordings of these events are presented in chart form. Interpretation of the charts, with the aid of applied anatomy, suggests an hypothesis of the probable sequence of events during an ideal feeding cycle under the test conditions. This emphasises the importance of complete coordination between breathing, sucking and swallowing. The feeding respiratory pattern and its relationship to the other events was different from the non-nutritive respiratory pattern. The complexity of the coordinated patterns, the small bolus size which influenced the respiratory pattern, together with the coordination of all these events when milk was present in the mouth, emphasise the importance of the sensory mechanisms. The discussion considers (1) the relationship between these results, those reported by other workers under other feeding conditions and the author's (WGS) clinical experience, (2) factors which appear to be essential to permit conventional bottle feeding and (3) the importance of the coordination between the muscles of articulation, by which babies obtain their nourishment in relation to normal development and maturation.