Elsevier

The Journal of Pediatrics

Volume 109, Issue 3, September 1986, Pages 515-519
The Journal of Pediatrics

Effect of maturation on oral breathing in sleeping premature infants*

https://doi.org/10.1016/S0022-3476(86)80134-2Get rights and content

To evaluate the influence of postnatal maturation on oral breathing, we measured nasal and oral ventilation during sleep and the ventillatory response to nasal occlusion in 11 preterm infants. Studies were repeated at 31–32, 33–34, and 35–36 weeks postconceptional age. Premature infants had rare episodes of spontaneous oronasal breathing during sleep. The frequency of oral breathing in response to nasal occlusion increased with advancing postconceptional age, from 8%±8% at 31–32 weeks to 26%±18% at 33–34 weeks and 28%±33% at 35–36 weeks. Oral breathing in preterm infants, unlike that in term infants, was characterized by intermittent airway obstruction leading to a significant decrease in respiratory rate, tidal volume, minute ventilation, and tcPo2 (P<0.005). When inspiratory (R1) and expiratory (RE) resistances during nasal and oral breathing were compared, R1 increased from 41±30 to 234±228 (P<0.004) and RE from 62±16 to 145±43 cm H2O·L−1·sec (P<0.004). The ability of preterm infants to use the oral route of breathing thus increases with advancing postnatal maturation, but its effectiveness may remain limited by high oral airway resistance.

References (10)

  • ShawEB

    Sudden unexpected death in infancy syndrome

    Am J Dis Child

    (1970)
  • MillerMJ et al.

    Oral breathing in newborn infants

    J Pediatr

    (1985)
  • SwiftPGF et al.

    Clinical observations on response to nasal occlusion in infancy

    Arch Dis Child

    (1973)
  • RodensteinDO et al.

    Infants are not obligatory nasal breathers

    Am Rev Respir Dis

    (1985)
  • CookCD et al.

    Studies of respiration physiology in the newborn infant. III. Measurements of mechanics of respiration

    J Clin Invest

    (1957)
There are more references available in the full text version of this article.

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*

Supported by Grants HL 25830 and 31173 from the National Heart, Lung, and Blood Institute, a grant from the American Lung Association, and a research award from Radiometer Corporation, Copenhagen.

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