It is remarkable how persistant bad science and old studies are.  Wolf and
Glass say in their book Feeding and Swallowiong Disorders in Infancy (1992):
"Traditionally it was thought that infants were obligate nose breathers (ie
that they were unable to breathe through their mouths)...Recent studies,
however, have shown this to be an inaccurate and incomplete
view...Rodenstein, et al (1989)...concluded that although nasal breathing
may be preferred in infants, it is not obligatory."  They go on to point
out:  "The response of premature infants to nasal occlusion is slightly
different from that of full-term babies and changes with increasing
gestational age...the consequences to the premature infant of continued oral
breathing would be increased work of breathing, which could lead to
diaphragmatic fatigue, hypercarbia, and hypoxia. Thus, all infants, term and
preterm are able to breathe through their mouths to some degree when faced
with nasal occlusion.  To do so, however, requires the baby to carry our a
series of complex motions...So while infants are not obligatory nose
breathers and can switch to oral breathing for short periods of time, nasal
breathing is clearly preferred from a respiratory standpoint."

Feeding is areobic exercise for babies.  They will discontinue feeding in
preference to being able to continue breathing.  Consequently, poor feeding
should really include some observation of respiratory performance.  I find
that respiratory compromise (sometimes secondary to swallowing dysfunction)
is an underrecognized cause of babies who are gaining poorly.
Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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