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Neonatal oral feeding difficulties due to sucking and swallowing disorders

Sudarshan R Jadcherla, MD, FRCP (Irel), DCH, AGAF
Section Editor
Steven A Abrams, MD
Deputy Editor
Melanie S Kim, MD


Safe and successful oral feeding in the neonate is dependent on the proper development of sucking and swallowing, and their coordination with breathing. Disruption of these coordinated functions can result in oral feeding difficulties leading to increased risk of apnea, bradycardia, failure to thrive, oxygen desaturation, or aspiration. As a result, identification of infants at risk for sucking and swallowing difficulties is important to prevent feeding disorders and potential serious complications.

This topic will review the development and physiology of sucking, swallowing, and aerodigestive protective mechanisms in the neonate. It will also discuss the evaluation and management approach for infants with feeding problems due to impaired sucking, swallowing, and their coordination. Swallowing dysfunction in older infants and children is discussed separately. (See "Evaluation of dysphagia in children" and "Aspiration due to swallowing dysfunction in infants and children".)


The terms used to discuss feeding difficulties in the newborn include the following:

Sucking refers to the oromotor phase of the feeding cycle, in which a partial vacuum is produced by the lips and tongue. It can be classified as follows:

Nutritive sucking involves extraction of fluids (eg, human milk or formula) from the mother's breast or bottle and is coordinated with swallowing.

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Literature review current through: Oct 2017. | This topic last updated: Jun 15, 2017.
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