Aspiration does not mean the end of a breast-feeding relationship

Cheryl J Hersh; Jessica Sorbo; Juan Manuel Moreno; Elizabeth Hartnick; M Shannon Fracchia; Christopher J Hartnick

doi:10.1016/j.ijporl.2022.111263

Aspiration does not mean the end of a breast-feeding relationship

Int J Pediatr Otorhinolaryngol. 2022 Oct:161:111263. doi: 10.1016/j.ijporl.2022.111263. Epub 2022 Aug 4.

Authors

Cheryl J Hersh¹, Jessica Sorbo¹, Juan Manuel Moreno², Elizabeth Hartnick³, M Shannon Fracchia⁴, Christopher J Hartnick⁵

Affiliations

¹ Department of Speech Language and Swallowing Disorders, Massachusetts General Hospital, MGH Professional Office Building, 3rd Floor, 275 Cambridge St., Boston, MA, 02114, USA.
² Universidad de Los Andes, Colombia, School of Medicine, Mass Eye & Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA.
³ Brown University, Providence, RI, 101 Revere St., Boston, MA, 02114, USA.
⁴ Department of Pediatric Pulmonology, Massachusetts General Hospital, Boston, MA, MGH Professional Office Building, 5th Floor, 75 Cambridge St., Boston, MA, 02114, USA.
⁵ Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, Mass Eye & Ear Infirmary, 243 Charles St., Boston, MA, 02114, USA. Electronic address: Christopher_hartnick@meei.harvard.edu.

PMID: 35947926
DOI: 10.1016/j.ijporl.2022.111263

Abstract

Objective: Breastfeeding is widely recommended as optimal nutrition for infants. However, there are no known publications on the impact of prandial aspiration of breast milk fed infants with dysphagia. The goal of this study was to assess pulmonary outcomes in infants with dysphagia who were given medical clearance for intake of breast milk.

Methods: This retrospective cohort study included review of 80 infants examined between August 2016 to March 2021. Patients were evaluated by an interdisciplinary team of providers in a tertiary pediatric aerodigestive center. Patient inclusion criteria included a VFSS with documented aspiration or penetration with thin liquids. Participants met inclusion criteria if given medical clearance for intake of breast milk despite aspiration risk. Pulmonary health was monitored for three months following medical clearance for the consumption of breast milk. Pulmonary illness was defined as development of bronchiolitis, wheezing, unexplained stridor during feeding, croup, pneumonia, or persistent bacterial bronchitis requiring medical intervention.

Results: Forty-three males (54%) and 37 females (46%) enrolled in the study with an age range of 1 month-6 months corrected age. Mean age at initial VFSS was 3.6 months. Twenty-six out of 80 (32.5%) had a report of a mild cough but did not require intervention. Eight out of 80 (10%) received a diagnosis of a pulmonary illness. Seventy-two out of 80 (90%) did not report pulmonary illness.

Conclusion: This pilot study reveals that the majority (90%) of this single institution, small sample size cohort of breast milk fed infants with documented oropharyngeal dysphagia remained healthy despite continued intake of breast milk. Prospective investigation is warranted to follow pulmonary health outcomes longitudinally and a head to head comparative study would be helpful to identify whether there were indeed significant changes to pulmonary health according to differential feeding regimens offered and followed.

Keywords: Aspiration; Breastfeeding; Breastmilk; Infants; Pulmonary illness.

MeSH terms

Breast Feeding*
Child
Deglutition Disorders* / etiology
Female
Humans
Infant
Male
Pilot Projects
Prospective Studies
Retrospective Studies