Case Report: Comparative Evaluation of Breastfeeding and Bottle-Feeding With NeoSAFE in a Preterm Infant With Laryngomalacia.

Background: Laryngomalacia is characterized by diminished laryngeal tone, leading to the dynamic prolapse of supraglottic tissues into the airway. This often results in inspiratory stridor, airway obstruction and feeding difficulties. This report presents quantitative data on respiratory-swallow coordination recorded by NeoSAFE during breastfeeding and bottle-feeding in a preterm infant with laryngomalacia.

Primary diagnosis: A preterm infant, born at 34+3 weeks of gestation and weighing 2090 g, was diagnosed with laryngomalacia, confirmed by clinical symptoms including inspiratory stridor and feeding difficulties, as well as by endoscopic evaluation.

Interventions: NeoSAFE, a device for real-time monitoring of swallowing and respiration, was used to record and analyze the infant's respiratory-swallow coordination during both breastfeeding and bottle-feeding. Key parameters included rhythmic swallowing rate, total swallow count, respiratory rate, and resting period.

Outcomes: The NeoSAFE data revealed a higher respiratory rate during bottle-feeding compared to breastfeeding, suggesting potential challenges in coordinating breathing with swallowing during bottle-feeding. In contrast, breastfeeding was associated with a shorter resting period and higher rhythmic swallowing rate, indicating more effective respiratory-swallow coordination. Clinically, less stridor was heard in the infant during breastfeeding, suggesting that breastfeeding was better tolerated.

Practice recommendations: Based on these findings, breastfeeding may be preferred for infants with laryngomalacia to improve respiratory-swallow coordination and reduce airway complications. The NeoSAFE device offers valuable insights into feeding mechanics, suggesting its utility in managing feeding strategies for infants with respiratory and swallowing challenges.