Risk Profiles of Infants =32 Weeks' Gestational Age with Oropharyngeal and Oesophageal Dysphagia in Neonatal Care

ABSTRACT

Background. Infants in neonatal intensive care are at risk of swallowing difficulties; in particular oropharyngeal dysphagia (OPD) and oesophageal dysphagia (OD). OPD is treated by speech-language therapists while OD is managed by doctors. Diagnosis of dysphagia is a challenge as equipment for instrumental evaluations is not readily available. Additional information to guide clinical assessment may be valuable. Objective. To determine whether risk profiles of infants (=32 weeks' gestation) in a neonatal intensive care unit (NICU) and diagnosed with OPD or OD were distinctly different from one another. Methods. Non-probability convenience sampling was used to select 49 participants. Based on modified barium swallow (MBS) examinations; three groups of participants were identified no dysphagia (n=11); OPD (n=13) and OD (n=25). Clinical data were collected to investigate associations between risk profiles and type of dysphagia. Results. Factors such as gestational age; birth weight; poor weight gain and Apgar scores showed no association with either type of dysphagia in the sample of infants with a mean gestational age of 35.53 weeks. Increased NICU stay; increased chronological age; problematic breastfeeding and use of tube feeding showed an association with OPD. Three risk factors; namely intrauterine growth restriction; premature rupture of membranes and nutritive sucking difficulties were associated with OD. Conclusion. Risk profiles associated with the two types of dysphagia may guide NICU personnel and speech-language therapists; especially in settings where no MBS equipment is available