In a newborn with Pierre Robin sequence, which sign would NOT be expected during oral-motor feeding evaluation?

• A. Ineffective suck
• B. Nasal regurgitation
• C. Anterior loss of liquid
• D. Frequent gagging or choking

Answer: (C)

Pierre Robin sequence creates airway obstruction from the tongue sitting back (glossoptosis) and often a cleft palate, so feeding is dominated by difficulties with how the bolus is contained and moved, not simply by lip seal. During an oral‑motor feeding evaluation you’d expect an ineffective suck because the small jaw and posterior tongue position hamper building suction. Nasal regurgitation is common because the velopharyngeal mechanism can’t fully seal the nasal cavity when the palate is clefted. Frequent gagging or choking reflects airway guarding and bolus misdirection during swallowing. An anterior loss of liquid would indicate poor front lip containment, which isn’t the characteristic pattern for PRS; leakage tends to be toward the nasal cavity or into the airway, not out the front.