Florinda Ceriani

Fetal Behavioral States

Main points: historical survey, sleep in children and premature infants, fetal micro-awakenings are not wakefulness, fetal ocular motions building blocks of the visual system, development of behavioral states, and differences and similarities with neonatal states

Swallowing, Sucking, and Handedness as Inferred from Fetal Thumb Sucking

Wide-ranging theories have flourished around fetal nutrition for centuries. The Greeks were somehow more accurate in their intuitions than many of those who followed them. Democritus and Epicurus thought that the unformed fetus ate and drank ‘per os’, through the mouth [1]. Hippocrates rightly assumed that the maternal blood flow nourished the embryo and even respiration emerged from the cord. Subsequently an almost ‘agricultural’ view of nutrition prevailed. Fetuses were regarded as passive creatures which simply absorbed nutrients from their mothers, who were equated to the earth and its fertile soil. Albertus Magnus thought that embryos absorbed nutrients ‘like a sponge’. Others, like Hildegard of Bingen, believed that retained menstrual blood was the primary source of fetal nourishment [1]. Menstruation ceased in the pregnant woman, and this was taken as a sign that menstrual blood was the fetus’s main food. Still others imagined the fetus branching out many vessels into the placenta, the socalled matrix, through which the nourishment was sucked in as from a fertile terrain.

Fetal Breathing Movements

Although aerial respiration only begins at birth, it is currently widely recognized that breathing has a long preparatory history during the 9 months preceding parturition. In describing the changes occurring at birth, most authors purposely omit the idiomatic expression ‘first breath’ and talk instead about a shift from periodic to continuous respiration.

Swallowing, Sucking, and Mouthing

Main points: swallowing and sucking as separate phenomena, their progressive integration with each other and with breathing, functions during late pregnancy, mouthing and similarities with nonnutritive sucking, swallowing, and sucking and mouthing indicators of state

Fetal Breathing Movements and Shallow Fetal Breathing Movements

Main points: role in lung development, apneic intervals and noncontinuous nature, increasing compatibility or less with other motions, consequences of their fetal features on the premature and neonate, and shallow fetal breathing as indicator of state

Localized or Isolated Movements

Main points: distinction and possible differential outcome from general movements, localized motions of various fetal parts, targeted (but not volitional) nature, compatibility with other motions and with rest, and possible functions during the last 15 weeks of pregnancy

Fetal Sensory Abilities

Main points: difficulties and ways of investigating sensory abilities; tactile perception and proprioception beginnings and importance of; pain: conclusions concerning fetuses in general; vestibular function, auditory function, olfaction, and taste: facts and factoids

Seemingly Trivial Fetal Motions: Yawning and Hiccups

Main points: characteristics, positioning, compatibilities, theories explaining them, their link with breathing, pulmonary and thoracic expansion, diaphragmatic development, and protection of the future airways from collapse and amniotic fluid aspiration

Fetuses: Facial Motions or Facial Expressions?

Main points: brief historical survey, fetal motions not expressions, emergence of different facial motions within states, preparatory function of, facial motions paving the way for face attraction and facial mimicry, or simple imitation at birth

Hiccups, Yawning and Gasping

The anatomical basis and, in particular, the functional significance of the three phenomena discussed in this chapter is still largely obscure. The main link uniting these phenomena is that they all begin to emerge during prenatal life. Additionally, despite being disparate phenomena, hiccups, yawning and gasping have all been associated with breathing and with some form of ‘primitive’ or ‘emergency’ respiration.