In newborns, swallowing can be triggered by a bolus as small as .01 to 
.02 mL. The longer the jaw is dropped during the "negative pressure" 
phase of sucking, the larger the bolus, so as Dr. Jack Newman says, 
watch for the pause. Very occasionally a babe will fool you that way, 
but not as often.

Multiple swallows are more likely to occur in preterm infants, 
especially if there is apnea during the run of swallows.
(Deglutition apnoea as indicator of maturation of suckle feeding in 
bottle-fed preterm infants. Hanlon, et al, Dev Med and Child Neuro, 
1997, 39, 534-542). This reference is more good ammunition for why 
preterm infants should not be bottle fed, if one can read between the lines.

Catherine Watson Genna, IBCLC  NYC

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