INFANTS ARE NOT OBLIGATORY NASAL BREATHERS

Abstract
It is widely believed that infants are obligatory nasal breathers. Infants (19) 1-230 days of age, were studied for respiratory response to acute nasal occlusion. Lips were kept apart. Oropharyngeal structures were monitored by fluoroscopy, whereas respiratory movements and oral flow were recorded. Before and during nasal occlusion tight apposition of the soft palate and the tongue, closing the oropharyngea listhmus was consistently observed. After a variable time (mean 7.8 s, range 0.6-32 s), the soft palate rose and oral breathing was initiated. Time required to mouth-breathe was related to age and/or conscious state, older and/or awake infants responding faster than younger and/or asleep infants. In 9 others, when nasal occlusion was performed with the mouth closed, results were comparable to those obtained in infants with mouths open. In 3 infants, electroencephalograph (EEG) records showed quiet non-REM sleep. Nasal occlusion resulted in an immediate arousal reaction, followed after a variable time by mouth breathing. Infants are not obligatory nasal breathers. They can breathe through the mouth by detaching the soft palate from the tongue, thus opening the oropharyngeal isthmus.

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