Ch. 5 Flashcards
Purposes of infant feeding:
- Satisfies _________
- Provides ________ for growth and development
- Provides ______-_______ and _____-____ stimulation
- Facilitates state ______ and maintain homeostasis
- Provides ______ and sense of well-being
- Enhances _______ and interactions with ______
- Serves as _______ for other functions, including speech
- Satisfies hunger
- Provides nourishment for growth and development
- Provides oral-sensory and oral-motor stimulation
- Facilitates state regulation and maintain homeostasis
- Provides calming and sense of well-being
- Enhances bonding and interactions with caregiver
- Serves as foundation for other functions, including speech
Oral anatomy of an infant is smaller and different than an adult:
- Oral cavity is _______ relative to _____ size.
- ______ pads (fat inside cheeks) are ______.
- There are no _______.
- Tongue rests _______ to alveolar ridge and contacts lower_______.
- Temporomandibular joint does not allow much ________ of jaw
- Oral anatomy is well suited for _______ (extension-retraction movements of the tongue).
Oral cavity is small relative to tongue size.
Buccal pads (fat inside cheeks) are large.
There are no teeth.
Tongue rests anterior to alveolar ridge and contacts lower lip.
Temporomandibular joint does not allow much movement of jaw
Oral anatomy is well suited for suckling (extension-retraction movements of the tongue).
Pharyngeal anatomy of an infant is smaller and different than that of an adult:
- Pharynx is ________.
- Tongue ______, soft palate, and ______ walls are in ______ approximation.
- Larynx is _________ the size of an adult’s and is ______ in the hypopharynx.
- High position of the infant larynx causes the _______ to pass superiorly to the free margin of the soft palate and project into the _______.
Pharynx is short.
Tongue base, soft palate, and pharyngeal walls are in close approximation.
Larynx is one-third the size of an adult’s and is high in the hypopharynx.
High position of the infant larynx causes the epiglottis to pass superiorly to the free margin of the soft palate and project into the nasopharynx.
Anatomy relevant to infant feeding:
Pharyngeal anatomy is well suited for the _____-_____-_____ synchrony.
______, ______, _____relationship are ideal for the suck-swallow-breathe synchrony.
Pharyngeal anatomy is well suited for the suck-swallow-breathe synchrony.
Head, chin, neck relationship are ideal for the suck-swallow-breathe synchrony.
Oral Phase:
________ ______ and generation of negative ______ occur for sucking
nipple compression and generation of negative pressure occur for sucking
Pharyngeal Phase:
_______, velum, and posterior pharyngeal provide driving force for _____ _______ to esophagus
tongue base, velum, and posterior pharyngeal provide driving force for bolus transfer to esophagus
Esophageal Phase:
_____ _______ ______ opens for bolus transfer to _______; ______ ______ _____ opens to allow bolus entrance into ______
upper esophageal sphincter opens for bolus transfer to esophagus; lower esophageal sphincter opens to allow bolus entrance into stomach
Coordination of _____, ______, ______ is crucial to prevent _______.
Suck-swallow-breathe ratio during is generally ______ or _______.
Decreased _______ during feeding may be a problem for some medically compromised infants.
Coordination of sucking, swallowing, and breathing is crucial to prevent aspiration (entry of material into the airway).
Suck-swallow-breathe ratio during is generally 1:1:1 or 2:1:1.
Decreased ventilation during feeding may be a problem for some medically compromised infants.
Significant _____, _____, _____ growth takes place in the first 2 to 3 years of life.
Oral cavity becomes ________ with mandibular growth.
Tongue tip moves _____ _______ alveolar ridge.
Teeth _______.
Pharynx ________.
Neuromuscular, particularly ________ function matures.
Growth and maturation lead to changes in ________ ___________pattern.
Significant oral, pharyngeal, and laryngeal growth takes place in the first 2 to 3 years of life.
Oral cavity becomes larger with mandibular growth.
Tongue tip moves back to under alveolar ridge.
Teeth erupt.
Pharynx elongates.
Neuromuscular, particularly oral-motor function matures.
Growth and maturation lead to changes in feeding and swallowing pattern.
Cleft Lip and Alveolus only:
- Infant may have initial problems achieving an adequate _____ ______ on the nipple.
- Inadequate lip seal may cause difficulty generating ______ _______ for sucking.
Infant may have initial problems achieving an adequate lip seal on the nipple.
Inadequate lip seal may cause difficulty generating negative pressure for sucking.
Cleft Palate Only:
- Depends on the extent of the cleft
- Infant may be unable to generate ______ _______ for suction.
- Infant may be unable to find a hard palatal surface for ______ of the nipple.
- Infant may experience ______ _________.
Depends on the extent of the cleft
Infant may be unable to generate negative pressure for suction.
Infant may be unable to find a hard palatal surface for compression of the nipple.
Infant may experience nasal regurgitation.
Cleft lip and palate:
-Infant may have all the difficulties noted above (lip and alveolus only, palate only), including these:
Difficulty achieving an adequate _____ ______ on the nipple
Inability to generate _____ _______ for suction
Inability to find _____ ______ for compression of the nipple
Nasal _______
Infant may have all the difficulties noted above, including these:
Difficulty achieving an adequate lip seal on the nipple
Inability to generate negative pressure for suction
Inability to find palatal surface for compression of the nipple
Nasal regurgitation
Postoperative recommendations vary among centers:
- Some _______ sucking following surgery and may may recommend the use of ______ or _______ instead.
- Some recommend supplemental _____ _______ for a short time.
- Some allow ______ feeding after surgery.
Postoperative recommendations vary among centers:
- Some discourage sucking following surgery and may may recommend the use of cup or spoon instead.
- Some recommend supplemental tube feeding for a short time.
- Some allow unrestricted feeding after surgery.
Anomalies that can contribute to a feeding or swallowing problem: \_\_\_\_\_\_\_\_\_ (small mandible) \_\_\_\_\_\_\_\_\_ (large tongue) \_\_\_\_\_\_\_\_\_ stenosis (narrowing) \_\_\_\_\_\_\_\_\_ anomalies \_\_\_\_\_\_\_\_\_ cleft \_\_\_\_\_\_\_\_\_\_\_\_\_ fistula \_\_\_\_\_\_\_\_ or cranial nerve involvement \_\_\_\_\_\_\_ (posterior displacement of the tongue in the pharynx) Midface \_\_\_\_\_\_\_ \_\_\_\_\_\_ \_\_\_\_\_\_\_\_ or lung disease \_\_\_\_\_\_\_ atresia
Anomalies that can contribute to a feeding or swallowing problem: Micrognathia (small mandible) Macroglossia (large tongue) Pharyngeal stenosis (narrowing) Vascular anomalies Laryngeal cleft Tracheoesophageal fistula Cortical or cranial nerve involvement Glossoptosis (posterior displacement of the tongue in the pharynx) Midface retrusion Congenital heart or lung disease Choanal atresia
Conditions that often affect feeding and swallowing include the following:
________ __________ sequence
____________ syndrome
____________ microsomia
Conditions that often affect feeding and swallowing include the following:
Pierre Robin sequence
Moebius syndrome
Hemifacial microsomia
Most infants with a cleft are able to feed with __________ ________________
Infant’s performance during the ______ feedings determines which _______ _______and technique will be best.
Most infants with a cleft are able to feed with simple modifications.
Infant’s performance during the initial feedings determines which feeding method and technique will be best.
Breastfeeding trials should be __________.
With cleft lip, breastfeeding is usually not a ___________.
With cleft palate, it is very challenging due to difficulties with __________ and _______
Options with cleft palate include:
__________ nursing
Modified ________/_________
______________ breast milk should always be recommended if breastfeeding is not possible.
Breastfeeding trials should be supported.
With cleft lip, breastfeeding is usually not a problem.
With cleft palate, it is very challenging due to difficulties with compression and suction.
Options with cleft palate include:
Supplemental nursing
Modified nipples/bottles
Pumping breast milk should always be recommended if breastfeeding is not possible.
Characteristics to consider when choosing a modified nipple
Pliability Shape Length Hole type Hole size
