Arousal has no effect on non-nutritive breathing–swallowing coordination during the first year of human life

Although the brainstem plays an important role in breathing–swallowing coordination (BSC), the role of suprabulbar structures is ill defined. Given the known decrease in global cerebral activity during sleep, the sleep–wake paradigm was used to elucidate suprabulbar influences. Non-nutritive BSC of 10 healthy human infants was monitored longitudinally during wakefulness and sleep from birth to 1 year of age. Time-locked recordings of submental muscle activity, nasal airflow, and thyroid acoustics enabled the categorization of swallows depending on the preceding and following respiratory phase. In contrast to the change in the overall pattern of BSC with age, and despite well-known marked postnatal cortical development over this time, no arousal-related differences were seen during the first year of life. This most likely reflects complete brainstem control of non-nutritive BSC in infants.