T R Shubert1, S Sitaram1, S R Jadcherla1,2. 1. Neonatal and Infant Feeding Disorders Program, Center for Perinatal Research, Nationwide Children's Hospital, Columbus, OH, USA. 2. Division of Pediatric Gastroenterology and Nutrition, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Abstract
BACKGROUND: Pacifier use is widely prevalent globally despite hygienic concerns and uncertain mechanistic effects on swallowing or airway safety. AIMS: The effects of pacifier and taste interventions on pharyngo-esophageal motility, bolus transit, and respiratory rhythms were investigated by determining the upper esophageal sphincter (UES), esophageal body, esophagogastric junction (EGJ) motor patterns and deglutition apnea, respiratory rhythm disturbances, and esophageal bolus clearance. METHODS: Fifteen infants (six males; median gestation 31 weeks and birth weight 1.4 kg) underwent high-resolution impedance manometry at 43 (41-44) weeks postmenstrual age. Manometric, respiratory, and impedance characteristics of spontaneous swallows, pacifier-associated dry swallowing and taste (pacifier dipped in 3% sucrose)-associated swallowing were analyzed. Linear mixed and generalized estimating equation models were used. Data are presented as mean ± SEM, %, or median (IQR). KEY RESULTS: Pharyngo-esophageal motility, respiratory, and impedance characteristics of 209 swallows were analyzed (85 spontaneous swallows, 63 pacifier- swallows, 61 taste- swallows). Basal UES and EGJ pressures decreased upon pacifier (p < 0.05) and taste interventions (p < 0.05); however, esophageal motility, respiratory rhythm, and impedance transit characteristics were similar with both interventions. CONCLUSIONS & INFERENCES: Oral stimulus with pacifier or taste interventions decreases UES and EGJ basal pressure, but has no effects on pharyngo-esophageal motility, airway interactions, or esophageal bolus transit. A decrease in central parasympathetic-cholinergic excitatory drive is likely responsible for the basal effects.
BACKGROUND: Pacifier use is widely prevalent globally despite hygienic concerns and uncertain mechanistic effects on swallowing or airway safety. AIMS: The effects of pacifier and taste interventions on pharyngo-esophageal motility, bolus transit, and respiratory rhythms were investigated by determining the upper esophageal sphincter (UES), esophageal body, esophagogastric junction (EGJ) motor patterns and deglutition apnea, respiratory rhythm disturbances, and esophageal bolus clearance. METHODS: Fifteen infants (six males; median gestation 31 weeks and birth weight 1.4 kg) underwent high-resolution impedance manometry at 43 (41-44) weeks postmenstrual age. Manometric, respiratory, and impedance characteristics of spontaneous swallows, pacifier-associated dry swallowing and taste (pacifier dipped in 3% sucrose)-associated swallowing were analyzed. Linear mixed and generalized estimating equation models were used. Data are presented as mean ± SEM, %, or median (IQR). KEY RESULTS:Pharyngo-esophageal motility, respiratory, and impedance characteristics of 209 swallows were analyzed (85 spontaneous swallows, 63 pacifier- swallows, 61 taste- swallows). Basal UES and EGJ pressures decreased upon pacifier (p < 0.05) and taste interventions (p < 0.05); however, esophageal motility, respiratory rhythm, and impedance transit characteristics were similar with both interventions. CONCLUSIONS & INFERENCES: Oral stimulus with pacifier or taste interventions decreases UES and EGJ basal pressure, but has no effects on pharyngo-esophageal motility, airway interactions, or esophageal bolus transit. A decrease in central parasympathetic-cholinergic excitatory drive is likely responsible for the basal effects.
Authors: A J Bredenoord; M Fox; P J Kahrilas; J E Pandolfino; W Schwizer; A J P M Smout Journal: Neurogastroenterol Motil Date: 2012-03 Impact factor: 3.598
Authors: William J Bulsiewicz; Peter J Kahrilas; Monika A Kwiatek; Sudip K Ghosh; Albert Meek; John E Pandolfino Journal: Am J Gastroenterol Date: 2009-08-18 Impact factor: 10.864
Authors: P S Jensen; I K Gulati; T R Shubert; S Sitaram; M Sivalingam; K A Hasenstab; M A El-Mahdy; S R Jadcherla Journal: Neurogastroenterol Motil Date: 2017-03-03 Impact factor: 3.598
Authors: Amanda S Mahoney; Molly O'Donnell; James L Coyle; Rose Turner; Katherine E White; Stacey A Skoretz Journal: Dysphagia Date: 2022-08-31 Impact factor: 2.733