Effect of nasal continuous positive airway pressure on the pharyngeal swallow in neonates

L. Ferrara, A. Bidiwala, I. Sher, M. Pirzada, D. Barlev, S. Islam, W. Rosenfeld, C. C. Crowley, N. Hanna

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Objective: Feeding neonates orally while on nasal continuous positive airway pressure (nCPAP) is a common practice. We hypothesize that pressurized airflow provided by nCPAP will alter the swallowing mechanism in neonates, increasing the risk of aspiration during oral feeding. Study design: Infants receiving nCPAP with a RAM cannula and tolerating at least 50% of their feeding orally were included in the study (one term; six preterm infants). Each participant underwent a videofluoroscopic swallow study while on nCPAP and off nCPAP. A non-parametric signed-rank test was used for paired data. Result: The incidence of deep penetration (P=0.03) and aspiration (P=0.01) decreased significantly off-nCPAP compared with on-nCPAP. However, the incidence of mild penetration (P=0.65) and nasopharyngeal reflux (P=0.87) remained the same under both conditions. Conclusion: Oral feeding while on-nCPAP significantly increases the risk of laryngeal penetration and tracheal aspiration events. We recommend caution when initiating oral feedings on nCPAP.

Original languageEnglish (US)
Pages (from-to)398-403
Number of pages6
JournalJournal of Perinatology
Issue number4
StatePublished - Apr 1 2017

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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