The cough is an immature reflex in prematures and even in some term infants.
The cough is the reflex that clears fluids from airways.  The immature
response to fluid in the airways is apnea (breath holding) followed by
attempts to swallow (to clear the passage ways).  Very late in the process
of aspiration a cough or choke might occur.  What would be more common to
observe would be the baby trying to bat the cup away (a weak and sort of
ineffectual move in the preterm or newborn, but observable if you watch for
it), nasal flaring, arms stiffening with fingers splayed, gaze aversion,
grimacing,  shutting down by closing eyes and trying to play possum.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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