Sam... we just can't compare infants to geriatrics.  An infant's diet is
all liquid which requires continued suck swallow breathe cycling.
Adequate growth is dependent on intake.  If any one has an opportunity
to view a modified barium swallow with an infant patient, it would be
worth your time.  Based on the Frazier water protocol, our Speech
Pathologists/Therapist use sterile water to evaluate swallows and
therapy to begin feeds with very, very limited volume to prepare and
work up to sucking and swallow skills for the baby to be able to take in
enough for a swallow study.  Water just would not be appropriate for
infant intake for obvious reasons.  Also, I am referring to situations
that aspiration is documented and not in question.  I am also referring
to those situations that require very thick texture to prevent
aspiration.  By the way, we would have already trialed and assessed the
infant with the breastmilk using slow flow nipple AND external pacing
both clinically and under videofluoro (xray).  
Angie Kirkwood, RN, BSN, IBCLC, RLC


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