Abstract:
BACKGROUND : Specific breastfeeding and swallowing characteristics in neonates with hypox-icischaemic
encephalopathy (HIE) have not yet been well described in the literature. Considering
the relatively high incidence of HIE in resource-poor settings, speech-language therapists
should be cognisant of the feeding difficulties in this population during breastfeeding.
OBJECTIVE : To systematically describe the breastfeeding and swallowing of a single case of a
neonate diagnosed with mild HIE from admission to discharge.
METHOD : A case study of a 2-day old neonate with mild HIE in a neonatal intensive care unit at
an urban teaching hospital, is presented. Data were prospectively collected during four
sessions in a 12-day period until the participant’s discharge. Feeding and swallowing were
assessed clinically, as well as instrumentally using a video-fluoroscopic swallow study.
RESULTS : After parenteral feeding, nasogastric tube feeding commenced. Breastfeeding was
introduced on Day 6, as it was considered a safe option, and revealed problematic rooting,
shallow latching, short sucking bursts, infrequent swallowing, and a drowsy state of arousal,
with coughing and choking. No penetration or aspiration was identified instrumentally. After
13 days, the neonate was breastfeeding safely.
CONCLUSION : Although the pharyngeal stage of swallowing was intact, symptoms of oral stage
dysphagia were revealed using a combination of clinical and instrumental measures.
Breastfeeding difficulties were identified, exacerbated by poor state regulation, which lead to
prolonged hospitalisation. The case study highlights the unexpected long duration of feeding
difficulties in an infant with mild HIE and indicates further research.
