Clinical identification of feeding and swallowing disorders in 0-6 month old infants with Down syndrome.

Feeding and swallowing disorders have been described in children with a variety of neurodevelopmental disabilities, including Down syndrome (DS). Abnormal feeding and swallowing can be associated with serious sequelae such as failure to thrive and respiratory complications, including aspiration pneumonia. Incidence of dysphagia in young infants with DS has not previously been reported.

Retrospective Analysis of Factors Leading to Pediatric Tracheostomy Decannulation Failure. A Single-Institution Experience.

Rationale: There is a lack of evidence regarding factors associated with failure of tracheostomy decannulation.

Objectives: We aimed to identify characteristics of pediatric patients who fail a tracheostomy decannulation challenge Methods: A retrospective review was performed on all patients who had a decannulation challenge at a tertiary care center from June 2006 to October 2013. Tracheostomy decannulation failure was defined as reinsertion of the tracheostomy tube within 6 months of the challenge.

Use of polysomnography to assess safe decannulation in children.

Background: Tracheostomy is a lifesaving procedure to secure the airway and provide respiratory support. The decision to decannulate has classically been an individual physician decision without consensus among experts. The objective of this retrospective study was to assess the safety and efficacy of a standard institutional protocol that utilizes the sleep laboratory to assist in the decannulation process.

The sleepy child.

Disorders of excessive sleepiness are uncommon in children. When they occur, the presentation is often consistent with the developmental age of the child and does not meet either historical or laboratory criteria determined with adults in mind. Because of these differences, the true diagnosis can be missed or inadequately treated.

Physiology of breathing and related pathological processes in infants.

There is little information describing control of breathing in the fetus and infant. The available data have largely been drawn from studies in animals and awake adults. Although the hierarchy of control of breathing is the same in adults and infants, feedback emphasis is different, with behavioral states and the sleep/wake cycle primary in the fetus and infant and integrated chemoreceptor response primary in the older child and adult.