development of the normal swallow

Question 1

what is the definition of feeding

Answer 1

Anticipatory reactions to food, preparing for intake of food, placement of food in the mouth and bolus management

Question 2

what is the definition of swallowing

Answer 2

The act of moving the food from the oral cavity and pharynx into the oesophagus.

Question 3

when can a baby swallow

Answer 3

15 weeks gestation

Question 4

what is the rooting reflex and when is it present

Answer 4

The head, mouth and tongue
turn in the direction of the stimulus and the mouth opens.

birth to 3-5 months

Question 5

what is the suckle swallow reflex and when is it present

Answer 5

Elicited by stroking the anterior third of the tongue or the centre of the lips.
Tongue thrusts forwards and backwards resulting in a swallow.

birth to 6 months

Question 6

what is the gag reflex and when is it present

Answer 6

Elicited by stimulus to posterior ¾ of the tongue or pharyngeal wall.
Pharynx constricts and elevates in response to stimulus
protective reflex

birth to 6 months

Question 7

what is the tongue protrusion reflex and when is it present

Answer 7

Baby pushes food out of the mouth when food is placed on the anterior tongue.
Protective reflex

birth to 4 months

Question 8

what is the bite reflex and when is it present

Answer 8

Stimulus to gum elicits rhythmic vertical biting movement of the jaw.
Protective reflex

birth to 6 months

Question 9

what is the transverse tongue reflex and when is it present

Answer 9

Tongue moves laterally if touch or taste is applied to the lateral edge of the tongue.

Present until ~ 6 months

Question 10

what is the difference between suckling and sucking

Answer 10

suckling: Characterised by forward and backward movement of tongue with backward phase - more pronounced.

sucking: Characterised by strong activity of the intrinsic muscles of the tongue. The body of the tongue raises and lowers with small vertical excursion of the jaw. - Replaces suckling patterns at about 6 months after birth.

Question 11

what is non-nutritive sucking

Answer 11

comforts and soothes
single sucks - long pauses

Question 12

what is nutitive sucking

Answer 12

continous sucking bursts
lasts 30-70 seconds

Question 13

what are characteristics of the swallow of a 3-6 month old

Answer 13

• Forward-backward tongue movement
• Jaw movement
• Lip involvement
• Head control develops
• Upper lip becomes more mobile.

solid food introduced - gag, bite and suckle swallow reflexes diminishes

Question 14

what are the characteristics of the swallow of a 6-9 month old

Answer 14

• Upper lip becomes more proficient.
• Emergence of incisors.
• Anterior jaw movements become more developed.
• Larynx has begun to descend.
• Begins to drink from a cup.
• Lips play increasing role with anterior seal

Question 15

what are the characteristics of the swallow of a 9-12 month old

Answer 15

• Lateralises food in the mouth.
• Emergence of chewing patterns and their continuing development.
• Here primitive reflexes disappear more fully

Question 16

what are the characteristics of the swallow of a 12-18 month old

Answer 16

• Lateral and rotary jaw movements in chewing.
• Lip closure on swallowing.
• Good lip seal on drinking from a cup.
• Smoother control of food from hand to mouth
• Independent feeding is progressive

Question 17

what are the characteristics of the swallow of a 18-24 month old

Answer 17

• Can lick lips with tongue.
• Begins to transfer food from one side of mouth to the other.
• Begins to suck with a straw.
• Rotary chewing is more mature

Question 18

what is the critical period for oro-motor development (FeeDing)

Answer 18

6 months to 2 yrs

Question 19

what are the main anatomical differences between adult and infant oral anatomy

Answer 19

• Size/Space differences
• Relative size of tongue or oral cavity reduces
• Fat pads providing stability for sucking, then diminish
• Larynx: descends from C3 to C6 by age 3 years
• Elongation of the pharynx, complete by 5 years
• Point of swallowing initiation becomes anatomically sooner

Question 20

what are the characteristics of the swallow of a 25-36 month old

Answer 20

Oro-pharyngeal and laryngeal structures continue
to mature.
Gag reflex now elicited from posterior 1/3 of
tongue.