what is the function of feeding and swallowing
- satisfies hunger
- reflexive sucking
- sensory and motor stimulation
- mother/caregiver-infant bonding
- oral motor skill development
T/F: for normal infant a&p structures are smaller and further in proximity
False; structures are smaller and CLOSER in proximity
what are the characteristics for normal infant a&p
- ideal for sucking (large tongue, large buccal pads, no teeth)
- close approximation of tongue, soft palate, pharyngeal wall
- high larynx adjacent to C1-C3
- epiglottis tubular, narrow
What are the S/S of pediatric dysphagia
- poor oral suction
- inadequate volume of intake (not able to suck and w/o adaptive equipment not able to get nutrition)
- lengthy feeding times
- nasal regurgitation (common through cleft palate or VPI)
- excessive air intake- spit up/bloating/crying/gassy
- coughing
- choking
- poor weight gain (b/c aspirating versus going into stomach and getting nutrition)
- excessive energy expenditure (fatigue b/c of lengthy feeding tie trying too hard and using more effort)
- discomfort during feeding (common, related to excessive air)
- stressful feeding (caretaker and infant) *if stressful its a problem
what is the physiology of the oral phase in infant feeding
- sucking to stabilize nipple, create negative pressure gradient for fluid flow, control bolus before swallow
- rooting reflux (helpful to grasp on nipple
- nipple compression
- negative pressure
what is the physiology of the pharyngeal phase in infant feeding
coordination of nasal breathing sucking and swallowing
what is the physiology of the esophageal phase in infant feeding
UES and LES
T/F: breathing thru nose when feeding should be 2:1
False: it should be 1:1
how can you assess airway protection during feeding in infants
- MBSS (used more often and easier with infant)
- FEES
what are general feeding modifications
- relax and comfort mom
- proper feeding equipment and methods
- upright positioning
- be consistent with feeding method
- manage air intake
- limit feeding to 30-45 minutes
Why would you need upright positioning during feeding
-because you need gravity to help
why would you limit feedings to 30-45 minutes
-to avoid fatigue/aggravation
what are proper feeding equipment and methods
- assistive squeezing (hand expressing breast milk) *with cleft kids it doesn’t often work
- breaks to rest or burp (every ounce or so to manage air intake)
- adaptive nipple/bottles (slower/faster flow rate (hole/slit), pliability, shape and size)
