Swallowing disorders and abnormal development in low risk term infants with gastroesophageal reflux

Abstract

Introduction: A higher incidence of swallowing and developmental disorders has been reported in term infants with gastroesophageal reflux (GER) and no other apparent disorders when compared to healthy. No physiological explanation for this has been suggested and none of this evidence is considered when infants with GER are assessed. Brainstem is involved in deglutition and other automatism regulation especially early in life and has been proposed to participate, in a vertical-integrative hierarchical system, with higher nervous structures in the regulation of functional status, attention, and emotional reactivity. Objective: Report the follow-up during the first year of life of three term infants born under low risk conditions apparently healthy except for GER. Search for a relation between GER, swallowing disorders and development in which nervous system could be involved. Methods: Three infants born under low risk conditions and diagnosed with GER within the first three months of life were followed for a year. Radiological study of swallowing, and brainstem auditory-evoked potentials (BAEP) were performed at involvement and at six months of age. Patients where monthly assessed with Bayley II infant developmental scale and a neurological evaluation. Results: The three patients showed deglutition, development and self-regulation alterations that may not be explained by GER itself. Alterations on BAEP were reported. Conclusion: Further research should be done to establish if GER in infancy could be an early indicator of brainstem and neurological disorganization that could be associated to other complications that could be prevented with early intervention.