Esophageal and upper esophageal sphincter motor function in babies

The incidence of concomitant feeding and airway-related disorders is high among premature infants and babies with congenital anomalies. The cause of these disorders is commonly attributed to foregut dysfunction, and the approach to diagnosis and management is largely empiric. Management strategies usually are based on the failure to improve feeding tolerance with advancing maturation and the presence of supraesophageal complications of reflux disease. Very little information exists about the functional development of deglutitive and airway-protective mechanisms in neonates. The purpose of this article is to review the available information on esophageal and upper esophageal sphincter (UES) motor function in human infants. Understanding the maturation of the motor functions of the pharynx-UES and esophagus and related airway-protection responses is essential for determining the pathophysiologic basis of feeding-related airway disorders.