Early Feeding Problems in Infants

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Questions and Answers

What is the purpose of infant feeding?

  • Providing nourishment, oral-sensory and oral-motor stimulation, calming, and enhancing bonding with caregivers (correct)
  • Providing nourishment only
  • Providing oral-sensory and oral-motor stimulation only
  • Calming and enhancing bonding with caregivers only

What are some factors that influence normal development in children?

  • Surgical procedures, frequent hospitalizations, and social isolation
  • ADHD and language delay
  • Brain structure and function, environmental stimulation, hearing and vision, motivation, attention, and normal anatomy and physiology (correct)
  • Overprotection of the child, verbal language, and gestures

  • Infants with cleft lip and/or palate may have difficulty achieving an adequate ______ seal or generating negative pressure for suction, leading to nasal regurgitation.

lip

What is the ratio of sucking, swallowing, and breathing during feeding?

<p>1:1:1 (D)</p> Signup and view all the answers

  • Various feeding methods and facilitation techniques can be used, including breastfeeding, modified nipples and bottles, and ______ and pacing techniques.

<p>positioning</p> Signup and view all the answers

What is the difference between developmental deficits in children with nonsyndromic clefts and syndromic clefts?

<p>Children with nonsyndromic clefts often have early deficits and delays that disappear with treatment and age, while children with syndromic clefts usually have more serious, long-lasting deficits (A)</p> Signup and view all the answers

What is the risk associated with cleft palate in terms of speech development?

<p>Cleft palate increases the risk of hearing loss, which can affect articulation, language, and resonance (D)</p> Signup and view all the answers

  • Feeding obturators may be used to assist infants with cleft palate in feeding, but most craniofacial centers no longer use ______.

<p>them</p> Signup and view all the answers

What are the differences in oral anatomy between infants and adults?

<p>Infants have smaller buccal pads and no teeth (A)</p> Signup and view all the answers

What is the purpose of feeding obturators for infants with cleft palate?

<p>To generate negative pressure for suction (D)</p> Signup and view all the answers

  • Oral hygiene is important for infants with clefts to prevent ______.

<p>infection</p> Signup and view all the answers

What is the effect of overprotection on verbal communication in children with clefts and craniofacial syndromes?

<p>Fewer demands for verbal communication (D)</p> Signup and view all the answers

  • Transitioning to a cup and introducing solid foods can be challenging and require appropriate ______.

<p>techniques</p> Signup and view all the answers

What is the purpose of a Modified Barium Swallow (MBS)?

<p>To help visualize oral, pharyngeal, and esophageal phases of swallowing (A)</p> Signup and view all the answers

What are some of the developmental risks associated with cleft palate only?

<p>Syndromes, developmental or cognitive deficits, attention deficits, learning disabilities and language delay, other forms of neurological or motor dysfunction, sensorineural hearing loss, velopharyngeal insufficiency, frequent hospitalizations, and social isolation (C)</p> Signup and view all the answers

  • Assessment of feeding problems can include clinical assessment by a feeding specialist, videofluoroscopic swallowing studies, and ______ evaluation of swallowing.

<p>fiberoptic endoscopic</p> Signup and view all the answers

What is the purpose of a Fiberoptic Endoscopic Evaluation of Swallowing (FEES)?

<p>To assess airway protection during swallowing (D)</p> Signup and view all the answers

What is the effect of structural and neurological problems on speech sound development in children with clefts and craniofacial syndromes?

<p>They may cause problems in speech sound development, and compensatory productions may develop. The longer the structure is abnormal, the harder it is to correct the child's speech (B)</p> Signup and view all the answers

Why is it important to monitor the child's speech and language development throughout the early years?

<p>To address any developmental delays (C)</p> Signup and view all the answers

What is the purpose of an Interdisciplinary Feeding Team Evaluation?

<p>To involve a team of feeding specialists for severe cases (B)</p> Signup and view all the answers

  • The Modified Barium Swallow (MBS) is also called the ______ swallow study.

<p>videofluoroscopic</p> Signup and view all the answers

What are the ultimate goals of feeding methods?

<p>Pleasurable experiences for infant and caregiver (D)</p> Signup and view all the answers

  • The ultimate goal of feeding method is adequate nutrition and weight gain, pleasurable experiences for infant and caregiver, enhancement of bonding process, and ______ stimulation for normal development.

<p>sensorimotor</p> Signup and view all the answers

Flashcards

Infant Feeding Purpose

Infant feeding provides nourishment, oral-sensory and oral-motor stimulation, calmness, and bonding with caregivers.

Infant Oral Anatomy

Infant oral cavities are smaller than adults, with larger buccal pads and no teeth.

Pharyngeal Anatomy

Infant pharynx is shorter, larynx is higher, and tongue, soft palate, and pharynx are closer together.

Sucking-Swallowing-Breathing Ratio

Crucial for preventing aspiration; typically 1:1:1 or 2:1:1 during feeding.

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Cleft Lip/Palate Feeding Difficulty

Difficulty achieving a good lip seal and negative pressure for suction, causing nasal regurgitation.

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Feeding Methods

Breastfeeding, modified nipples/bottles, and positioning/pacing techniques are used.

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Feeding Obturators

Devices used with cleft palate for feeding, but seldom used now.

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Oral Hygiene Importance

Essential to prevent infection in infants with clefts.

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Transitioning to Cup/Solids

Challenging transition for infants involving appropriate techniques.

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Feeding Problem Assessment

Includes clinical assessment, videofluoroscopic swallowing studies, and FEES.

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Modified Barium Swallow (MBS)

Videofluoroscopic swallowing study, visualizing swallowing phases.

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Fiberoptic Endoscopic Evaluation of Swallowing (FEES)

Using an endoscope to assess airway protection during swallowing.

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Interdisciplinary Feeding Team

Team of specialists for severe cases including, gastroenterologist etc.

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Alternative Feeding Methods

Orogastric/nasogastric (NG) or gastrostomy (G) tube for severe cases.

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Feeding Goals

Adequate nutrition, weight gain, pleasurable experience, and development.

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Study Notes

Early Feeding Problems in Infants: Anatomy, Physiology, and Management

  • Infant feeding serves multiple purposes including providing nourishment, oral-sensory and oral-motor stimulation, calming, and enhancing bonding with caregivers.
  • Infant oral anatomy is different from adults, with a smaller oral cavity, larger buccal pads, and no teeth.
  • Pharyngeal anatomy is also smaller, with a shorter pharynx, a high larynx, and close approximation of tongue base, soft palate, and pharyngeal walls.
  • Synchrony between sucking, swallowing, and breathing is crucial to prevent aspiration, and the ratio during feeding is generally 1:1:1 or 2:1:1.
  • Infants with cleft lip and/or palate may have difficulty achieving an adequate lip seal or generating negative pressure for suction, leading to nasal regurgitation.
  • Various feeding methods and facilitation techniques can be used, including breastfeeding, modified nipples and bottles, and positioning and pacing techniques.
  • Feeding obturators may be used to assist infants with cleft palate in feeding, but most craniofacial centers no longer use them.
  • Oral hygiene is important for infants with clefts to prevent infection.
  • Transitioning to a cup and introducing solid foods can be challenging and require appropriate techniques.
  • Assessment of feeding problems can include clinical assessment by a feeding specialist, videofluoroscopic swallowing studies, and fiberoptic endoscopic evaluation of swallowing.
  • Management of feeding problems may involve compensatory strategies and modifications to feeding methods and techniques.
  • Postoperative recommendations for infants with clefts vary among centers, with some recommending the use of a cup or spoon instead of sucking and others allowing unrestricted feeding after surgery.Feeding and Swallowing Evaluation and Management

Modified Barium Swallow (MBS):

  • Also called the videofluoroscopic swallow study
  • Involves a radiologist and a speech-language pathologist
  • Helps visualize oral, pharyngeal, and esophageal phases of swallowing
  • Can identify aspiration, response to aspiration, nasopharyngeal reflux, and effectiveness of compensatory strategies

Fiberoptic Endoscopic Evaluation of Swallowing (FEES):

  • Involves passing an endoscope through the nose to view pharyngeal and laryngeal structures
  • Helps assess airway protection during swallowing
  • Provides information about sensory threshold in the pharynx and larynx
  • Allows clear view of structures and management of secretions
  • Temporary loss of view when velopharyngeal valve closes during swallow

Interdisciplinary Feeding Team Evaluation:

  • Recommended for severe cases
  • Involves a team of feeding specialists, including gastroenterologist, nutritionist, nurse, speech-language pathologist, occupational therapist, behavioral psychologist, otolaryngologist, pulmonologist, and consulting radiologist

Alternative Feeding Methods for Severe Cases:

  • Orogastric or nasogastric (NG) tube for supplemental feeding
  • Gastrostomy (G) tube for infants with abnormal oral reflexes or poor airway protection while swallowing

Ultimate Goals of Feeding Method:

  • Adequate nutrition and weight gain
  • Pleasurable experiences for infant and caregiver
  • Enhancement of bonding process
  • Sensorimotor stimulation for normal development

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