This is a red flag for some underlying motor/neurologic deficit.  In such
cases, lackof choking or gagging is *not* a reassuring sign.  Such
compromised infants and children frequently  exhibit "silent aspiration",
that is, they inhale food and fluids into the lungs without overt signs of
discomfort.

A videoflouroscopic modified barium swallow study is still the gold standard
in diagnosis for swallowing disorders.

Needless to say,if infant is to be offered nutrition by mouth, breastmilk is
one of the safer things to aspirate.  And if oral intake is contra-indicated
at this time, anything mom pumps for tube feedings is head and shoulders
above what the drug companies can offer.

Best of luck with this dyad.

Karen Kavesh in Philadelphia
Speech-Language Pathologist
Breastfeeding peer counselor
Mom of 2

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html