Evolution of Feeding and Developmental Outcomes in Infants With Moderate Hypoxic-Ischemic Encephalopathy: A Pilot Study.

The purpose of the study was to describe the evolution of outcomes among full-term infants with moderate hypoxic-ischemic encephalopathy (HIE); from their early swallowing and feeding abilities during hospitalization, to their later developmental outcomes at 6 and 12 months. Four participants with moderate HIE were recruited. Early feeding and swallowing were assessed using the Neonatal Feeding Assessment Scale and video fluoroscopic swallow studies. Developmental assessments were conducted at 6 and 12 months using the Rossetti Infant-Toddler Language Scale and Vineland-3 Scale. All participants displayed atypical outcomes throughout the study, including oropharyngeal dysphagia initially during hospitalization. All participants were discharged on oral feeds but some breastfeeding difficulties persisted. Variable but pervasive developmental delays were found among all participants at 6 and 12 months. This study emphasizes the need for consistent early intervention from the neonatal period onward, for all infants with moderate HIE. Future studies should use larger cohorts, longer follow-up, and correlational designs.

A swallowing and breastfeeding intervention programme for small and sick neonates embedded in kangaroo mother care.

Available evidence of oral sensorimotor interventions for small neonates is not strong. Evidence of interventions for sick term neonates is largely lacking. Studies are limited by risk of bias and inconsistency. Evidence of interventions relying on a single stimulation technique only appears to be low to very low. Ongoing research is required.Contribution: We describe a five-component neonatal swallowing and breastfeeding intervention programme embedded in the practice of kangaroo mother care (KMC). Drawing on oropharyngeal physiology, neonatology, neurodevelopmental care, breastfeeding- and KMC science, the programme is the product of collaboration between a speech-language therapist and a medical doctor, and their team. Its implementation is dependent on coaching mothers and the neonatal care team. Researchers are invited to determine outcomes of the programme.

Age-specific communication functioning of young children with cleft lip and palate in a South african database.

Objective : To determine the age-specific communication functioning of children with cleft lip and palate (CLP) in the age groups of 1 to 11 months, 12 to 23 months, and 24 to 48 months. Design : A retrospective, descriptive, cross-sectional survey design was employed. Participants : Purposive sampling was implemented as a nonrandomized sampling method. The data sets of 227 participants, between the ages of 1 month and 48 months, and their families were investigated. Setting : The assessment data were extracted from an early communication intervention database at the Clinic for High Risk Babies at the University of Pretoria. Results : The findings revealed that expressive and receptive language and listening skills presented as the most vulnerable communication areas across all three age groups. The cumulative effect of the risk factors was the greatest in the 12- to 23-month age group, as this group presented with the highest frequency of delayed communication development. Relative strengths were found across all age groups in three areas: average cognitive skills, gross motor development, and displaying an appropriate variety of communication functions. Conclusions : The findings are confirmed by other studies and suggest that young children with CLP in the 12- to 23-month age group may be the most vulnerable for the emergence of communication delays. The vulnerable areas of communication development should be integrated as goals in a focused early communication intervention approach to the treatment of the young population with CLP.

Exploring swallowing, feeding and communication characteristics of toddlers with severe acute malnutrition.

BACKGROUND:  Severe acute malnutrition (SAM) is associated with cognitive and motor deficits. Little is known about the swallowing, feeding and communication characteristics of hospitalised toddlers with SAM, limiting the abilities of speech-language therapists to provide effective early intervention. OBJECTIVE:  To explore the background, swallowing, feeding and communication characteristics of toddlers with SAM during in-patient nutritional rehabilitation. METHOD:  An exploratory, prospective, collective case-study was conducted with three hospitalised toddlers who were 12-18 months old and independently diagnosed with SAM, at least 1 week after transitioning to oral feeding. Detailed case histories were compiled through medical file perusal and parent interviews. Cross-sectional clinical bedside assessments were completed with the Rossetti Infant-Toddler Language Scale and Schedule for Oral-Motor Assessment. RESULTS:  All three participants had a history of feeding difficulties before admission. Despite intact pharyngeal swallows, heterogeneous oral-sensorimotor dysfunction and disruptive feeding behaviours were identified. Risk for oropharyngeal dysphagia indicates the need to modify dietary consistencies to prevent prolonging recovery or SAM relapse. Participants had mild-to-moderate language delays, particularly in interaction-attachment, play and language comprehension, with an atypical moderate receptive and mild expressive language delay profile. None of the participants were referred for speech-language therapy. CONCLUSION:  This exploratory research showed the oral-sensorimotor skills, swallowing and communication characteristics of children with SAM. Speech-language therapists could address oral-sensorimotor functioning, feeding difficulties and communication interaction delays before discharge to community-based management for SAM. Further investigation with a larger sample size is recommended.Contribution: Novel description of the oral-sensorimotor skills for feeding and the communication development of three severely malnourished toddlers with HIV and tuberculosis co-infection was presented. The complexity of the three cases is highlighted.

Evolution of swallowing and feeding abilities of neonates with hypoxic-ischaemic encephalopathy during hospitalisation: A case series.

PURPOSE: To describe the evolution of swallowing and feeding abilities of neonates with hypoxic-ischaemic encephalopathy (HIE) during hospitalisation. METHOD: A longitudinal cohort study was used. Twenty-nine participants (median age 39.0 weeks [IQR = 2.0 weeks]) with mild (n = 7), moderate (n = 19) and severe (n = 3) HIE were included. Clinical swallowing and feeding assessments were conducted at introduction of oral feeds and at discharge using the Neonatal Feeding Assessment Scale (NFAS). Videofluoroscopic swallow studies (VFSS) supplemented the NFAS before discharge. RESULT: Approximately two thirds of participants showed symptoms of oropharyngeal dysphagia (OPD) during initial NFAS and VFSS. Significantly fewer OPD symptoms occurred at discharge NFAS (p = 0.004). Endurance during non-nutritive sucking (p < 0.001) and nutritive sucking (p < 0.001) significantly improved. Nine participants (31.0%) demonstrated penetration or aspiration. Most aspiration events were silent (60%). Instrumental assessment identified pharyngeal phase dysphagia more effectively than bedside evaluation. High proportions of participants displayed OPD symptoms regardless of HIE severity. The correlation between OPD severity and the length of hospitalisation (p = 0.052) was not significant. CONCLUSION: All grades of HIE should be considered for early intervention by speech-language pathologists before discharge. Findings may be valuable to neonatal feeding teams.

Preliminary reliability of South African adaptation and Northern Sotho translation of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up.

BACKGROUND: There is a shortage of validated autism screening tests in the 11 official languages of South Africa. The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/FTM), a validated and well-known screening test, had already been adapted (in English) and translated into Northern Sotho for use in South Africa. OBJECTIVES: The aim was to collect pilot data to determine the preliminary reliability and feasibility of the two tests to confirm the equivalence of the adaptation and translation. METHOD: The study was conducted in a peri-urban community in South Africa. Twenty-one first-language Northern Sotho caregivers of children aged between 18 and 48 months were recruited by employing snowball sampling. The participants were asked to complete the Northern Sotho and the culturally adapted English M-CHAT-R/F, which were presented in random order. RESULTS: The preliminary content validity and equivalence were evident, with no difference at the 5% interval of the Wilcoxon signed rank test. All 21 toddlers screened presented with a low risk for autism following the recommended execution of the Follow-Up section for the toddlers in the medium risk category. All participants completed the two screening tests, with none indicating unfamiliar words or constructs. A higher preference for the English adapted version was found but a need for the Northern Sotho screening test was also evidentConclusion: The Northern Sotho translation of the M-CHAT-R/F, as well as the adapted English version, appears feasible and is ready for comprehensive validation.

Oropharyngeal Dysphagia in Breastfeeding Neonates with Hypoxic-Ischemic Encephalopathy on Therapeutic Hypothermia.

Purpose: To identify symptoms of oropharyngeal dysphagia (OPD) in breastfeeding neonates with hypoxic-ischemic encephalopathy (HIE) on therapeutic hypothermia (TH). Early identification of feeding problems in neonates with HIE by speech-language therapists (SLTs) may prevent secondary complications of OPD such as aspiration pneumonia and death. Materials and Methods: Twenty-eight full-term neonates with HIE (mean chronological age = 4.5 days) and 30 healthy term controls were prospectively recruited for this case-control study. Participants with HIE (mild [n = 15], moderate [n = 11], severe [n = 2]), diagnosed by pediatricians, received whole-body TH. Feeding was clinically evaluated by an SLT using the Preterm Infant Breastfeeding Behavior Scale. Results: Twenty-five neonates (89.2%) had at least one symptom of OPD. Falling asleep during feeding, noticeable oral secretions, coughing, and flaring nostrils were symptoms of OPD most frequently identified. The HIE group displayed limited arousal during breastfeeding and had less obvious rooting, shallower latching onto the breast, and more single sucks in comparison to term newborns. The HIE group had significantly more closed eyes and minimal movement during breastfeeding, while controls showed the quiet-alert state ideal for breastfeeding. Conclusions: OPD was identified in the majority of infants with HIE. Underlying the appearance of an inactive neonate with HIE may be OPD that could be overlooked if not investigated. Interprofessional collaboration between SLTs, pediatricians and nurses to determine feeding-readiness is imperative. SLTs may assist in decision-making to improve safety of breastfeeding in this population. This study contributes to the small body of research on early breastfeeding of neonates with HIE.

Reliability and validity of the neonatal feeding assessment scale (NFAS) for the early identification of dysphagia in moderate to late preterm neonates.

BACKGROUND: A clinical feeding assessment instrument to assist with early identification of oropharyngeal dysphagia (OPD) in neonates was developed. OBJECTIVE: To investigate the validity and reliability of the Neonatal Feeding Assessment Scale (NFAS) in comparison to the modified barium swallow study (MBSS) as gold standard. METHOD: A within-subject design was implemented. A group of 48 late premature neonates (mean gestational age 35.5 weeks) were sampled in the neonatal intensive care unit. RESULTS: The NFAS consists of six subsections, including physiological stability, infant state, stress cues, screening of muscle tone and control, oral peripheral examination and feeding/swallowing assessment. 93% of participants (14/15) received confirmatory diagnosis of OPD on MBSS. The NFAS presented with high sensitivity (78.6%) and specificity (88.2%) scores. The positive predictive value was 78.6%. Subsequently the accuracy of the NFAS to identify the presence of OPD accurately was 85.4% when compared to MBSS. Inter-rater reliability was determined on 35% of the sample. The inter-rater agreement on overall instrument outcome was substantial beyond chance. CONCLUSION: The NFAS may be of use to clinicians to support the early identification of OPD in this population, especially in resource constrained settings working without access to MBSS and to reach under served neonates.

Corrigendum: Gestational age and birth weight variations in young children with language impairment at an early communication intervention clinic.

No abstract available.

Breastfeeding skills of full-term newborns and associated factors in a low-and-middle-income setting.

BACKGROUND: Normative information on the breastfeeding of term newborns may guide clinicians in early identification of breastfeeding difficulties and oro-pharyngeal dysphagia (OPD), and may support optimal breastfeeding practices. OBJECTIVE: To describe breastfeeding skills of term newborn infants in a South African hospital, a lower-middle-income setting, and investigate associations between infants' feeding and other factors. METHOD: One breastfeeding session of each of the 71 healthy newborn full-term infants (mean chronological age=1.9 days; mean gestation=39.1 weeks) was evaluated using the Preterm Infant Breastfeeding Behavior Scale (PIBBS), suitable for use with term newborns. RESULTS: All participants were exclusively breastfed. Thirteen participants (18%) were HIV-exposed. There was no significant difference in the findings of the PIBBS between HIV-exposed and unexposed participants. Most newborns had obvious rooting, latched deeply onto the nipple and some of the areola, had repeated long sucking bursts (mean length=16.82 sucks/burst), and swallowed repeatedly. Most participants were in either the drowsy or quiet-alert state, which are optimal behavioural states for breastfeeding. One to two-hourly on-demand feeds was significantly associated with mothers who had normal births and did not use galactogogues to promote lactation. CONCLUSION: Results may be used for early identification of OPD in newborns. The findings may be useful to primary care clinicians.

Significance of speech production errors on cross-linguistic processing in Sepedi-English individuals with bilingual aphasia: a case series analysis.

BACKGROUND: Bilingual aphasia forms a significant part of speech-language pathologists' (SLP) caseload, globally, and specifically in South Africa. Few tools supporting clinical decision-making are available due to limited understanding of typical and disordered cross-linguistic processing (how the languages interact). Speech errors may provide insight about "hidden" bilingual mechanisms. OBJECTIVES: To determine what speech errors can impart about cross-linguistic processing, as well as, associated language and impairment variables in Sepedi-English individuals with aphasia. METHOD: The case series included six participants, purposively selected from three rehabilitation sites in South Africa. Detailed language and clinical profiles were obtained. Participants performed a confrontation naming task in their most dominant (MDL) and less dominant language (LDL). Responses were audio recorded, transcribed, and analyzed for overall accuracy and error type in MDL and LDL; verified by a Sepedi-speaking linguist and a qualified SLP. RESULTS: (1) No statistically significant differences in MDL-LDL naming accuracy were found, supporting recent literature of simultaneous inter-activation of both languages and shared word retrieval mechanisms. All types of speech errors occurred, and semantic errors were produced most frequently and consistently in each participant's MDL and LDL. (2) Language proficiency, language recovery patterns, and aphasia type (Broca's and Anomic) and severity (mild and/or moderate) appeared to be more strongly linked to cross-linguistic processing than Sepedi-English linguistic differences and age of acquisition of both languages. CONCLUSIONS: Participants with bilingual aphasia may use typical cross-linguistic and word retrieval mechanisms, concurring with current theories of bilingualism. Findings are preliminary, warranting investigations of other language tasks, modalities, pairs, and related variables.

Prevalence and associated prenatal and perinatal risk factors for oropharyngeal dysphagia in high-risk neonates in a South African hospital.

BACKGROUND: The prevalence of neonatal oropharyngeal dysphagia (OPD) in high-risk infants in lower-middle-income countries is unknown. OBJECTIVES: To determine the prevalence and associated risks for OPD in high-risk neonates in order to allow timely intervention for OPD, minimising negative outcomes. METHOD: A prospective cross-sectional observational study was conducted in an urban hospital in South Africa. Clinical feeding assessments were conducted using the Neonatal Feeding Assessment Scale with all available neonates in neonatal care. RESULTS: The sample of 81 high-risk neonates (mean chronological age = 11.7 days; standard deviation = 15.6 days) had been feeding orally for 2 days and were approaching discharge. Fifty-two participants (64.2%) had OPD. Risks likely associated with OPD included breech presentation, septicaemia and other infections, spending more than 1 day on a warm table or incubator, neurological conditions, prenatal exposure to maternal smoking, siblings with mental or neurological disability, participants with congenital disorders, preterm birth ( 37 weeks), low birth weight ( 2500 g), or retinopathy of prematurity. CONCLUSION: An unexpected high prevalence of OPD was found in neonates already deemed ready for oral feeding and approaching discharge. Timely early involvement of the Speech-Language Therapists (SLTs) in decision-making about feeding readiness may prevent serious complications of neonatal OPD. Findings may inform South African neonatal clinicians. The study provides motivation for early intervention from SLTs before the infant and mother are discharged from high care and dispersed to communities where intervention services may be scarce.

Gestational age and birth weight variations in young children with language impairment at an early communication intervention clinic.

BACKGROUND:  South Africa presents with high preterm birth (PTB) and low birth weight (LBW) rates (14.17%). Numerous conditions characterised by language impairment are associated with LBW and/or PTB. Speech-language therapists may fail to identify older children whose language impairment may have originated from LBW and/or PTB. OBJECTIVE:  To describe the frequency of LBW and/or PTB, in comparison with full-term birth, and associated conditions in children at an early communication intervention (ECI) clinic. METHODS:  Retrospective data of 530 children aged 3-74 months were analysed, with 91.9% presenting with language impairment. RESULTS:  Almost 40% had LBW and/or PTB, and late PTB was the largest category. Factors associated with LBW and/or PTB were prenatal risks, including small-for-gestational age, perinatal risks, including caesarean section, and primary developmental conditions. Secondary language impairment was prevalent, associated with genetic conditions and global developmental delay. CONCLUSION:  The frequency of LBW and/or PTB was unexpectedly high, drawing attention to the origins of language impairment in almost 40% of the caseload at the ECI clinic.

Incidence and description of dysphagia in infants and toddlers with tracheostomies: a retrospective review.

OBJECTIVE: An increasing number of infants and toddlers with tracheostomies were identified at a large paediatric referral hospital in South Africa. They are at risk for swallowing and feeding difficulties, however, there is limited literature reporting the incidence and describing the dysphagia in this population, and no literature specific to a developing country. The purpose of this study was therefore to report the incidence and describe the dysphagia in infants and toddlers with tracheostomies at a large paediatric referral hospital in South Africa. METHOD: A retrospective, descriptive review of the medical records of 80 infants and toddlers (0-3 years) with tracheostomies between 2002 and 2004 was conducted. RESULTS: Eighty percent (64/80) of the participants presented with dysphagic symptoms. Oral phase dysphagia was reported in 81.25% (52/64), pharyngeal phase dysphagia in 60.9% (39/64) and oesophageal phase dysphagia in 79.7% of the dysphagic participants. CONCLUSIONS: Infants and toddlers with tracheostomies are at increased risk for dysphagia. Multiple risk factors for dysphagia associated with tracheostomies, underlying medical conditions and the context of a developing country were identified in the study population.

Breastfeeding and swallowing in a neonate with mild hypoxic-ischaemic encephalopathy.

BACKGROUND: Specific breastfeeding and swallowing characteristics in neonates with hypoxic-ischaemic encephalopathy (HIE) have not yet been well described in the literature. Considering the relatively high incidence of HIE in resource-poor settings, speech-language therapists should be cognisant of the feeding difficulties in this population during breastfeeding. OBJECTIVE: To systematically describe the breastfeeding and swallowing of a single case of a neonate diagnosed with mild HIE from admission to discharge. METHOD: A case study of a 2-day old neonate with mild HIE in a neonatal intensive care unit at an urban teaching hospital, is presented. Data were prospectively collected during four sessions in a 12-day period until the participant's discharge. Feeding and swallowing were assessed clinically, as well as instrumentally using a video-fluoroscopic swallow study. RESULTS: After parenteral feeding, nasogastric tube feeding commenced. Breastfeeding was introduced on Day 6, as it was considered a safe option, and revealed problematic rooting, shallow latching, short sucking bursts, infrequent swallowing, and a drowsy state of arousal, with coughing and choking. No penetration or aspiration was identified instrumentally. After 13 days, the neonate was breastfeeding safely. CONCLUSION: Although the pharyngeal stage of swallowing was intact, symptoms of oral stage dysphagia were revealed using a combination of clinical and instrumental measures. Breastfeeding difficulties were identified, exacerbated by poor state regulation, which lead to prolonged hospitalisation. The case study highlights the unexpected long duration of feeding difficulties in an infant with mild HIE and indicates further research.

Breastfeeding Characteristics of Late-Preterm Infants in a Kangaroo Mother Care Unit.

OBJECTIVE: To describe the breastfeeding characteristics of late-preterm infants (LPIs) in a kangaroo mother care (KMC) unit. MATERIALS AND METHODS: In a 20-bed KMC unit, the breastfeeding of 73 purposively-selected LPIs' (mean gestational age: 34.8 weeks) was observed once-off, using the Preterm Infant Breastfeeding Behavior Scale. Participants' mean age was 9.5 days, mean number of days in the unit was 3.1 days, and mean number of days breastfeeding was 7.5 on observation. RESULTS: Only 13.7% of participants were directly breastfeeding without supplementary naso- or orogastric feeding/cup-feeding and 86.3% received supplementary cup-feeding of expressed breast milk. Most participants did not exhibit obvious rooting (83.5%) and although most latched-on (97.3%), those who did, latched shallowly (93%). The mean longest sucking burst was 18.8 (standard deviation: 10.5) and approximately half the participants swallowed repeatedly (53.4%). The mean breastfeeding session duration was 17.8 minutes, but most participants breastfed for less than 10 minutes (76.7%). No statistically significant differences in breastfeeding characteristics were detected between participants of different chronological ages. A general trend toward more mature behaviors in participants' breastfeeding for more days was present for many breastfeeding characteristics. More infants exhibited the most mature behavior for each breastfeeding characteristic when the environment was quiet, rather than noisy and disturbing, except for depth of latching (quiet: 0%, disturbance: 15.2%). CONCLUSION: LPIs in this sample presented with subtle breastfeeding difficulties, highlighting their need for breastfeeding support. Further research is required to examine the effect of KMC on breastfeeding in LPIs.

Social participation in working-age adults with aphasia: an updated systematic review.

BACKGROUND: A previous systematic review found limited data regarding social participation in working-age people with aphasia (PWA). A review of recent studies may reveal more information on challenges in reestablishing social roles. METHOD: The aim was to provide an updated systematic review on social participation in PWA under 65 years of age. Studies from 2005 to 2017 were searched from Scopus, Pubmed, and Psychinfo. Search terms were derived from the International Classification of Functioning, Disability and Health (ICF) and the Aphasia- Framework for Outcomes Measures (A-FROM). Aspects of domestic life, interpersonal relations and interactions, education and employment, and community, civic, and social life were investigated. RESULTS: From 2864 initial hits, 11 studies were identified, all of which were on the American Speech-Language-Hearing Association (ASHA) Level III of evidence. The studies indicated that participation in domestic life is reduced and PWA showed reduced social networks, loss of friendships and changes in the quality of marital relations. Few PWA returned to work or spent time on education. Limitations in community, civic, and social life were noted and there were contradictory findings on the impact of contextual factors on social participation. There was an increase in research into contextual factors impacting on social participation in PWA and in the use of conceptual frameworks in the last decade. CONCLUSIONS: While the ICF conceptual framework is increasingly used, no studies used the A-FROM. There is greater use of standardized assessments and larger sample sizes.

Preliminary psychometric performance of the Neonatal Feeding Assessment Scale.

OBJECTIVE: The objective was to determine the preliminary psychometric performance of a new clinical feeding scale to diagnose oropharyngeal dysphagia (OPD) in neonates. METHODS: Twenty neonates with a median gestational age of 35 weeks were evaluated using the Neonatal Feeding Assessment Scale (NFAS) and modified barium swallow studies (MBSS). The results were compared. RESULTS: Nine of the 20 participants presented with OPD on the NFAS. Comparison of the scale's results with instrumental MBSS indicated that all participants without OPD were correctly excluded (100% sensitivity). The specificity was 78.6%, indicating that three participants were falsely identified with OPD on the scale. Inter-rater reliability was determined on 50% (n = 10) of the sample. Substantial agreement (80%) was obtained between two raters in five of the six sections of the scale and on the diagnostic outcome. CONCLUSION: The preliminary performance of the scale appears to be promising. A further validation study will take place.

Development of a clinical feeding assessment scale for very young infants in South Africa.

BACKGROUND: There is a need for validated neonatal feeding assessment instruments in South Africa. A locally developed instrument may contribute to standardised evaluation procedures of high-risk neonates and address needs in resource constrained developing settings. OBJECTIVE: The aim of the study was to develop and validate the content of a clinical feeding assessment scale to diagnose oropharyngeal dysphagia (OPD) in neonates. METHOD: The Neonatal Feeding Assessment Scale (NFAS) was developed using the Delphi method. Five international and South African speech-language therapists (SLTs) formed the expert panel, participating in two rounds of electronic questionnaires to develop and validate the content of the NFAS. RESULTS: All participants agreed on the need for the development of a valid clinical feeding assessment instrument to use with the neonatal population. The initial NFAS consisted of 240 items across 8 sections, and after the Delphi process was implemented, the final format was reduced to 211 items across 6 sections. The final format of the NFAS is scored using a binary scoring system guiding the clinician to diagnose the presence or absence of OPD. All members agreed on the format, the scoring system and the feeding constructs addressed in the revised final format of the NFAS. CONCLUSION: The Delphi method and the diverse clinical and research experience of participants could be integrated to develop the NFAS which may be used in clinical practice in South Africa or similar developing contexts. Because of demographically different work settings marked by developed versus developing contexts, participants did not have the same expectations of a clinical dysphagia assessment. The international participants contributed to evidence-based content development. Local participants considered the contextual challenges of South African SLTs entering the field with basic competencies in neonatal dysphagia management, thereby justifying a comprehensive clinical instrument. The NFAS is aimed at clinicians working in Neonatal Intensive Care Units where they manage large caseloads of high-risk neonates. Further validation of the NFAS is recommended to determine its criterion validity in comparison with a widely accepted standard such as the modified barium swallow study.

Suck, swallow and breathing coordination in infants with infantile colic.

BACKGROUND: There appears to be a perception amongst parents and in popular literature that infantile colic is caused by feeding difficulties. Limited support for this perception is found in scientific literature. Whilst there is scientific evidence that suck, swallow and breathing are key components of successful feeding, these components and the coordination thereof in infants with colic have not been extensively researched. OBJECTIVE: The objective of the study was to explore the suck, swallow and breathing coordination in infants with infantile colic and compare it with infants without the condition. METHOD: An assessment protocol for suck, swallow and breathing coordination was compiled from literature. This protocol was performed on a research group of 50 infants, independently diagnosed with infantile colic, and a control group of 28 infants without the condition. All participants were from two rural towns in the North­West province, South Africa, selected with a snowball selection method and strict selection criteria. The study followed a static comparison group design. RESULTS: A significant difference in the key components of feeding and the presence of colic in participants of four age categories were found. The correlation between postural control and the presence of infantile colic were sustained in participants from 2­19 weeks old. CONCLUSION: Suck, swallow and breathing were found to be significantly associated with infantile colic. The findings should be investigated further. It appears that speech-language therapists may play an expanding role in infantile colic.