2.2 Development of Swallowing in Infants

Question 1

What does the Jaw provide for swallowing in infants?

2

Answer 1

Provides stability

Helps providing negative pressure

Question 2

What does the Tongue provide for swallowing in infants?

2

Answer 2

It is large to create a central groove and to wrap the edges around the nipple.

Question 3

What does the Hard Palate provide for swallowing in infants?

Answer 3

Provide the positive pressure along with the tongue

Question 4

What does the Velum provide for swallowing in infants?

Answer 4

Provides the posterior seal

Question 5

What is different about the Pharynx in infants?

3

Answer 5

High hyoid position – less elevation

Larynx grows and descends.

Naso pharynx to hypopharynx is curve-like.

Question 6

What are the two types of sucking behaviors?

Answer 6

Non-nutritive

Nutritive

Question 7

What is Non-Nutritive sucking?

Is apnea present?

Answer 7

Rhythmic movements on a pacifier, finger

No - Infants breathe

Question 8

What is Nutritive sucking?

Is apnea present?

Answer 8

Sucking for nutritive purposes

Yes - Apneic period.

Question 9

What is the Suck-Swallow ratio for Nutritive sucking?

When does it begin?

Answer 9

Suck-swallow ratio of 1:1

32 weeks of gestational age

Question 10

What is a Suckle?

Answer 10

Primitive and backward-forward movement of the tongue

Question 11

What is a Suck?

Answer 11

More efficient – up and down movement of the tongue

Question 12

What is a Rooting Reflex?

What is its purpose?

Answer 12

When a baby’s mouth, lips, cheek, or chin are touched by an object, the head and mouth turn towards the object and the baby opens its mouth.

This reflex allows a baby to seek out and grasp a nipple.

Question 13

What initiates a Suck/Swallow Reflex?

When does it begin?

Answer 13

After opening the mouth when baby’s lips and mouth area are touched, suckling or sucking movements begin.

As liquid moves into the mouth, the tongue moves it to the back of the mouth for swallowing.

Question 14

What is a Tongue Thrust Reflex?

What is its purpose?

Answer 14

When the lips are touched, the baby’s tongue moves out of the mouth.

This reflex allows for feeding from the breast or bottle but not from a spoon or cup.

Question 15

What is a Gag Reflex?

What happens when it is too sensitive?

Answer 15

When an object, such as a spoon or solid food, is placed way back in the mouth, the object is quickly moved back out of the mouth on the tongue.

It can affect normal swallow patterns

Question 16

What may happen to feeding reflexes in infants who are delayed in their development?

Answer 16

These reflexes may be stronger or weaker, or last longer than normal

Question 17

What are typical Mouth Patterns seen in the first 5 months of age?

(4)

Answer 17

Suck/swallow reflex

Tongue thrust reflex

Rooting reflex

Gag reflex

Question 18

What are typical Hand + Body Skills seen in the first 5 months of age?

(2)

Answer 18

Poor control of head, neck, trunk

Brings hands to mouth around 3 months

Question 19

What are typical Feeding Skills/Abilities seen in the first 5 months of age?

(2)

Answer 19

Swallows liquids

Pushes most solid objects from mouth

Question 20

What are typical Mouth Patterns seen from 4-6 months?

6

Answer 20

Draws in upper/lower lip when spoon removed from mouth

Up-and-down munching movement

Can transfer food from front to back of tongue to swallow

Tongue thrust and rooting reflexes begin to disappear

Gag reflex diminishes

Opens mouth when sees spoon approaching

Question 21

What are typical Hand + Body Skills seen from 4-6 months?

2

Answer 21

Sits alone easily

Transfers objects from hand to mouth

Question 22

What are typical Feeding Skills/Abilities seen from 4-6 months of age?

(2)

Answer 22

Begins to eat ground or finely chopped food

Begins to eat small pieces of soft food

Question 23

What are typical Mouth Patterns seen from 8-11 months of age?

(3)

Answer 23

Moves food from side-to side in mouth

Begins to curve lips around rim of cup

Begins to chew in Rotary Pattern (diagonal movement
of the jaw as food is moved to the side or center of the mouth)

Question 24

What are typical Hand + Body Skills seen from 8-11 months of age?

(2)

Answer 24

Sits alone easily

Transfers objects from hand to mouth

Question 25

What are typical Feeding Skills/Abilities seen from 8-11 months of age?

(2)

Answer 25

Begins to experiment with spoon but prefers to feed self with hands

Drinks from a cup with less spilling

Question 26

What food is appropriate for infants from birth to 3 months of age?

(1+2)

Answer 26

LIQUIDS ONLY

• Breast milk
• Infant formula with iron

Question 27

What food is appropriate for infants 4-7 months of age?

1+3

Answer 27

ADD SEMISOLID FOODS

• Infant cereal with iron
• Strained vegetables*
• Strained fruit*

(*may be started later in the
age range)

Question 28

What food is appropriate for infants 8-11 months of age?

1+9

Answer 28

ADD MODIFIED TABLE FOODS

• Mashed or diced soft fruit
• Mashed or soft cooked
  vegetables
• Mashed egg yolk
• Strained meat/poultry
• Mashed cooked beans or peas
• Cottage cheese, yogurt, or cheese strips
• Pieces of soft bread
• Crackers
• Breast milk, iron-fortified formula, or fruit juice in a cup