Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
|
Sucking and Breathing in Infants
|
Infants take very short breaths. An infant CAN suck and breathe at the same time, as can an adult. However, NOBODY can breathe and swallow at the same time.
|
|
|
Upper Lip & Spoon
|
In a normal swallow, the upper lip touches the spoon. Touching the upper lip to the spoon is a way to stimulate a more mature swallow in a person who is getting food off of spoon with teeth.
|
|
|
Most speech structures in utero...
|
develop by the end if the first trimester.
|
|
|
The last thing to develop...
|
respiration.
|
|
|
Respiration...
|
trumps everything, including swallowing. Without it we die.
|
|
|
Normal birth weight
|
7 pounds.
|
|
|
Normal birth length
|
19 inches.
|
|
|
Gram conversion
|
454 grams to a pount
|
|
|
Reflux
|
is a huge problem, especially in premies. There is not a strong lower esophageal sphincter, so babies are prone to getting reflux, which can sometimes lead to aspiration.
|
|
|
Stomach capacity at birth...
|
is one ounce. After a week or so, it is higher, but in babies this does not develop very quickly.
|
|
|
Two main issues with premies
|
- Respiration
- GI tract |
|
|
In a 3 month old, you would assess:
|
- Oral mech
- Suck, swallow, breathe patterns - Alertness state - Reflexes - Written history - Crying - General motor abilities |
|
|
What would you expect in a two year old with velocardiomegaly (velocardiofacial) syndrome?
|
- Cardiac problems, distracted jaw, 20ish teeth, class 3 occlusion.
- Not much ability to use their teeth, cleft palate, twisted teeth, supernumerary teeth. |
|
|
What would you expect in a five year old with velocardiomegaly (velocardiofacial) syndrome?
|
- The kid has probably had a swallow study, if not he needs one because you need to make some decisions
- GERD, dentition, nasal regurgitation, tongue movement, hypernasialtiy, respiratory problems, cardiac problems. - Psychosocial issues - Swallowing issues - poor bolus preparation and lateralization, aspiration risk because of descended larynx. - Look for pneumonia history. |
|
|
Reducing Oral Aversions
Who? |
- Infants and children with oral hypersensitivity
- infants and children who have been previously tube fed - infants with a hyperactive gag reflex - premature infants. |
|
|
Reducing Oral Aversions
What? |
Reducing oral aversions for feeding
|
|
|
Reducing Oral Aversions
Why? |
To:
- Decrease the infant or child's oral sensitivity - Increase tolerance of touch - Establish positive oral experiences - Establish trust that is necessary for mealtime success |
|
|
Reducing Oral Aversions
How? - In General |
Starting points will vary among children. Some will not allow you near the face, and some will have trouble with external stimuli in the oral cavity. If the child has high muscle tone, carry out these techniques with a deep, firm pressure. If the child has low muscle tone, proceed with gentle tapping.
|
|
|
Reducing Oral Aversions
How? - Specifically Starting Point Outside the Oral Cavity |
1. Stimulate the least sensitive body part. You may have to start at the extremities and work your way in. Follow the child's lead and work your way in. (Rapport building for infants?)
2. To increase the child's tolerance for being touched, gradually work your way toward the face using either deep, firm pressure or gentle, rhythmic patting. 3. Once touch to face is tolerated, start from the farthest point such as ears or forehead, and work your way toward the lips. 4. If the child becomes tense and uncomfortable throughout the process, stop and reestablish comfort level. |
|
|
Reducing Oral Aversions
How? - Specifically Starting Point Inside the Oral Cavity |
1. Firm pressure to outer part of upper gum, beginning at midline and moving in anerior-posterior direction. Then, move to lower gum and hard palate.
2. Using your finger or an object, press firmly or tap gently from tongue tip, working your way slowly to the center and front of child's tongue. 3. If possible, allow child to hold your hand with the object or use her own finger with your help. 4. If the child gags, remove the stimuli and close the child's mouth. 5. Using a stimulus other than your own finger, move from the center of the tongue to he anterior and lateral teeth/gums. 6. Give frequent breaks, because intraoral stimulation increases saliva production and the child will need to swallow more frequently. |
|
|
"Food Rules"
Basic to all children Especially pertinent in kids with behavioral feeding disorders. |
- Maintain regular mealtimes; add planned snacks on a feeding schedule.
- Limit mealtimes to no more than 30 minutes. - Do not allow child to graze throughout the day. Only water should be presented between meals. - Provide a neutral feeding atmosphere don't force food or comment on the amount that was eaten. - Protect the floor with a sheet and expect messes. - No game playing. Never use food as a reward or present. - Give small portions of solids first. - Give liquids at the end of the meal. - Encourage self-feeding (finger foods, utensils) - Remove the food after 10-15 minutes if the child is no longer eating or only playing with the food. - Remove the food immediately if the child throws the food in anger. - Reserve "clean up" for after the meal. Don't wipe the child's hands or mouth until the meal is finished. |
|
|
Three categories of "food rules"
|
Scheduling rules, environmental rules, and procedural rules.
|
|
|
Intervention for behavioral feeding disorders
Who and Why |
Who - non-organic failure to thrive, people with aversive behaviors, sometimes tube to oral feeding.
Why - To develop age-appropriate feeding skills and successful child/caregiver interaction. |
