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You enter the examination room and see a mother and her baby. The mother, who is a professional singer, is very worried because she has noticed that during breastfeeding the baby repeatedly stops sucking to breathe. “Why,” asks the mother, “does her child not breathe at the same time?” She is so anxious that she thinks about switching to bottle feeding. You ask her why she did not expect her baby to notice breathing while breastfeeding. He immediately picks up a recently published book on the human voice,This is the Voice, By John von Colapinto, 1 book he read before giving birth from a wallet է points to page 42. [relative to adults], the newborn’s throat is piled up near the mouth, near the opening of the velvet. This helps with breastfeeding, creating a smooth airway from the nose to the lungs (so that babies can suck on their mother’s breasts without “sucking” and “rising in the air” during feeding. Milk flows down the raised throat and into the stomach) … ” ային cell phone և starts showing multiple sites that present the same phenomenon. appeared New York Times: On February 10, 20214 by the famous non-fiction author Mary Roach, who states: “This [the high larynx] makes it possible to constantly suck. “Unlike adults, children can swallow and breathe at the same time.” He also tells you that he has read many of Roach’s books, and therefore thinks that if Roach mentions it in a book review, it “should” be true.

Of course, now that you have calmed this mother, your curiosity awakens. Is there any truth in this notion? If so, what is the underlying anatomy և physiology?

The notion that newborns can breathe and swallow at the same time has no merit. This is absolutely false. Speech Speech / Language Pathologist (SLP) or Occupational Therapist (OT), who treats neonatal dysphagia, looks for normal sucking / swallowing / breathing patterns, especially 1-3 pacifiers per breath.

However, as suggested by many sources, despite being unreliable, this simultaneous notion of breathing / swallowing is ingrained in popular literature և even found in the chapter on pediatric anatomy in the 2019 textbook; Pediatric surgery.5 So what is the story behind this idea?

The concept that children can swallow and breathe at the same time has a long history dating back to the 19th century. This early story was summarized by Piper in 1963, 6 who confirmed this claim. However, its strongest supporters, based primarily on the high relative position of the baby’s throat (Figure 1:compared to adults, Edmund Krelin, Ph.D., Ph.D. Functional anatomy of the newborn, 7 և his student, Ph.D. Je եֆրի Թ. Lighting: In a 1973 book, Krelin stated: “Throat raising [in newborns] “It directs the opening of the throat into the nostril so that the baby can breathe freely while the fluid passes through his throat.” 7:

In a subsequent 1977 article by Lightman, Krelin եր ra erald Konlog 8 rejected 9 earlier studies that did not detect this phenomenon. [Figure 2] in water և milk, did not describe it: interconnected [our italics] throat և throat. ” 8:

Dr. Krelin died in 2004, but Lightman և colleagues continued to support the concept, albeit with less confidence, over time. For example, in 1993 to Ph oy S. Reidenberg, Ph.D. և Lightman announced.

“In infants and young infants, the high position of the throat will allow most of the respiratory and digestive tracts, which are similar to those of other terrestrial mammals, to exist. These essentially separate pathways prevent the absorption of food խառն by the mixture of inhaled air. “These pathways can also allow the baby to breathe and swallow some fluids almost simultaneously, as shown in non-human primates.”

Lightman continues to support this concept in print until at least 2017,10, despite much evidence that it is not real.

“These essentially separate pathways prevent the mixture of inhaled food and inhaled air. “These ways can allow a baby to breathe and swallow some fluids almost at the same time as non-human primates.”

It seems that Krelin և Lightman was unaware of an earlier study by Thomas George Hole Wilson, FRCSI, FRCSE, FRCS, FACS, FRSM, MRIA, HRHA, which showed significant variability in the neonatal throat. This variability will preclude any possible “locking” of the epiglottis ուկ soft palate when swallowing. Moreover, Wilson also stated that the tissues of the newborn’s throat are softer, and therefore more flexible than those of adults, assuming that the epiglottis will not be able to merge with the soft palate in any way that forms a sealed wave.

A much more recent study 12 described newer epiglottis softer in the newborn than in the adult. In addition, this study also noted that children, especially those with high epiglottis, who may complain of a foreign body in their throat, are often not a cause for concern, as high epiglottis may simply be a normal anatomical variant. Of course, this increases the likelihood that some of the newborn corpses examined by Krelin accidentally had this variant.

1981 Wilson SL13 specifically addressed the question of whether infants can swallow և breathe at the same time using instrumental measurement of premature infants ակ concluded: “In contrast to this [Crelin/Laitman] We found intermittent respiratory distress associated with spontaneous non-feeding swallows. “Although we do not have any data on feeding swallowing, we have not found any major differences between the mechanism of swallowing of the unborn swallow in these infants.

Above we have presented a scenario according to which swallowing / breathing everywhere can take time for the doctor և and / or the therapist ունենալ have financial costs for the baby’s family (the cost of the office visit); In addition, this concept may cause breastfeeding failure անհ Unnecessary anxiety in the patient’s family.

At the same time, we are talking about the possible unintended consequences of the theory of breathing / swallowing for OT և SLP students. These students are taught the correct information about breastfeeding in the classes, but when they search the internet inevitably, they will find significantly different information. This discrepancy is likely to be noticed in the classroom or privately with the teacher. This script happened to one of us and eventually led to the writing of this essay.

The idea that babies can breathe and swallow at the same time joins the very long list of often misunderstood / dangerous misconceptions about baby care. Such a concept is mentioned in the article Slate: About 15 of these topics were that children, regardless of age, should not be fed at night, as this exaggeration could contribute to the development of socialism. According to another pediatrician, children should start eating cereal at 2 days of age, as breast milk and formula are deficient.

The current widespread dissemination of the simultaneous theory of breathing / swallowing on the Internet գր in the popular book հատկապես is particularly striking given that Leitman’s support for this theory is clearly weakening. In this article, we hope to start the way to change the mindset և realize that changing the “mindset” does not happen quickly or quickly. Moreover, we know that in trying to change this mindset, we can only “lean on the windmills.” However, if one does not try, the mindset will never change.

Links:

1. Collapinto, J .. This is the Voice. Simon և Schuster, New York. 2021:

2. Biology. https://www.livescience.com/7468-hyoid-bone-changed-history.html; Dental sleep practice. https://dentalsleeppractice.com/ce-articles/evolution-human-oral-airway-apnea/; Brian Palmer, DDS. https://www.brianpalmerdds.com/ Available to everyone on August 10, 2021.

3. Youtube: Entered on August 10, 2021. https://www.youtube.com/watch?v=4R639t1da6I:

4. New York Times. Available August 10, 2021. https://www.nytimes.com/2021/02/10/books/review/this-is-the-voice-john-colapinto.html

5. Stringer M. Anatomy of a newborn և child. In Puri P, Hollwarth M, eds. Pediatric surgery. Spinger-Verlag; Berlin; 2019: 83-101:

6. Piper A. Childhood ության childhood brain function. Bureau of Consultants. New York: 1963

7. Crelin, ES. Functional anatomy of the newborn. Yale University Press. New Haven. 1973

8. Laitman, JT, Crelin ES. Konlog GJ. 1977. The function of the epiglottis in ape-man. Yale Journal of Biology and Medicine. 1977; 50: 43-48:

9. Laitman JT, Reidenberg J. Specialization of the human upper respiratory and upper digestive systems, which is seen through relative developmental anatomy. Dysphagia. 1993; 8: 318-325: doi: 10.1007 / BF01321770:

10. Laitman, JT, Noden DM, Van der Water TR: Throat formation. From Hox genes to critical regions. In: Sataloff RT, ed. Phonetics. Plural edition; San Diego; 2017 : 13-30:

11. Wilson TG Stridor in childhood. Journal of Laryngology and Otology. 1952; 66: 437-451: doi: 10.1017 / s0022215100047903:

12. Petkar N, orgalas G, Bhatacharya A. JABFM. 2007; 20: 495-7: doi: 10.3122 / jabfm.2007.05.060212:

13. Wilson SL, Thach BT, Brouillette, Abu-Asaba: Coordination of human infant respiration. J Appl Physiol Respir Environ Exerc Physiol. 1981; 50: 851-858: doi: 10.1152 / jappl.1981.50.4.851:

14. Crelin ES. Newborn anatomy. Atlas. Leah եբ Febiger. Philadelphia. 1969

Slate. Entered on August 10, 2021. https://slate.com/human-interest/2012/11/bad-baby-advice-a-history.html)

16. Bosma JF, Truby HM, Lind J. Cry for a newborn baby. Acta Paed Scand. 1966; 49: (Suppl 61): 62-92:

This article was originally published on Contemporary OB / GYN®.

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