A Dynamical Systems Approach to Infant Oral Feeding and Dysphagia: From Model System to Therapeutic Medical Device

A dynamical systems approach to infant feeding problems is presented. A theoretically motivated analysis of coordination among sucking, swallowing, and breathing is at the heart of the approach. Current views in neonatology and allied medical disciplines begin their analysis of feeding problems with reference to descriptive phases of moving fluid from the mouth to the gut. By contrast, in a dynamical approach, sucking, swallowing, and breathing are considered as a synergy characterized by more or less stable coordination patterns. Research with healthy and at-risk groups of infants is presented to illustrate how coordination dynamics distinguish safe swallowing from patterns of swallowing and breathing that place premature infants at risk for serious medical problems such as pneumonia. Coordination dynamics is also the basis for a new medical device: a computer-controlled milk bottle that controls milk flow on the basis of the infant's coordination patterns. The device is designed so that infants may gradually take complete control of milk flow as they begin to discover the relation between swallowing and breathing.