bubble_chart Overview

Milk aspiration pneumonia occurs when milk is inhaled into the respiratory tract during swallowing or when residual milk is inhaled into the lungs due to prolonged emptying time in the pharynx. When vomiting or milk regurgitation occurs, milk is inhaled into the respiratory tract, often with predisposing factors.

bubble_chart Etiology

disease cause

（1）、Swallowing disorder: Premature infants have immature swallowing reflexes and uncoordinated swallowing movements, making them prone to milk aspiration. Brain injury or cranial nerve disorders can also cause sluggish or incomplete swallowing reflexes, prolonging the time it takes for milk to clear the pharynx. Sometimes, due to neuromuscular incoordination in the pharynx, milk may partially enter the esophagus, partially flow out through the nasal cavity, and partially be aspirated into the respiratory tract, leading to pneumonia.

（2）、Esophageal malformation: In cases of esophageal atresia, milk cannot pass from the esophagus into the stomach and remains in the pharynx, where it is aspirated into the lungs along with saliva.

（3）、Esophageal dysfunction: After entering the esophagus, milk refluxes back into the pharynx and is then aspirated.

（4）、Severe cleft palate or harelip: Cleft palate generally does not affect swallowing, but severe defects can make sucking difficult, leading to aspiration.

bubble_chart Diagnosis

(1) Symptoms of the primary disease causing aspiration: For example, infants with swallowing dysfunction may experience milk flowing out from the nasal cavity, accompanied by cough and sometimes cyanosis. Infants with esophageal atresia may have milk retained in the pharynx, producing gurgling sounds during breathing. Those with tracheoesophageal fistula may exhibit choking, shortness of breath, and cyanosis during feeding. Individuals with esophageal insufficiency are prone to milk regurgitation.

(2) Respiratory symptoms and signs: The severity (grade III) is related to the amount and frequency of aspiration. Those with minor or occasional aspiration primarily present with bronchitis, manifesting as cough, wheezing, and shortness of breath. Larger amounts of aspiration can lead to pneumonia, while a single massive aspiration may cause asphyxia and respiratory arrest. After respiration resumes, significant shortness of breath and widespread lung rales may occur. Chronic and repeated aspiration can result in necrotizing pneumonia, eventually leading to pulmonary fibrosis or complicating bronchiectasis.

(3) X-ray findings: In the early stage, due to bronchial irritation by foreign substances, incomplete obstruction leads to bronchospasm, presenting on X-ray as extensive pulmonary emphysema and bronchial inflammatory changes, widened hilar shadows, thickened lung markings, or patchy inflammatory shadows. Repeated aspiration involving the interstitium can lead to interstitial pneumonia.

bubble_chart Treatment Measures

﹝Treatment﹞

Immediate endotracheal intubation to suction milk from the trachea. Strengthen nursing care, ensure warmth, and maintain airway patency. Initially provide nutrition intravenously, then switch to nasogastric or oral feeding once the condition improves. Use antibiotics to prevent secondary infections and treat the underlying disease cause.