Feeding #2 Flashcards
0 – 6 months mealtime participation
Largely dependent
7-24 months
Emerging independence
2 years
Predominantly independent
Feeding development: Birth to 3 months
Oral reflexes (suck, swallow, rooting, gag), suckle/swallow 1:1:1
Feeding development: 3 to 6 months
Suckle/swallow 20:1, first semi-solid foods, munching, should be able to hold head up by end
Feeding development: 6 to 9 months
Sucking pattern ins predominant, lip movements can close around spoon, vertical chewing pattern, lateral tongue movements, poor bite (true bite, not reflex), cup drinking with single sips
Feeding development: 9 to 12 months
Longer sucking than 6 months, cup driving (consecutive sip and swallow), improved grading of movement, Lips actively remove food from spoon, more jaw control, tongue begins lateral movement, more controlled bite, vertical some diagonal chewing pattern
Down syndrome chewing issues
Enlarged tongue, can’t get diagonal and lateral movements to clear food out
Feeding development: 12 to 18 months
Weaning from nipple, successful cup drinking, integrated chewing pattern (grinding, diagonal movements, more controlled lateral tongue movements), spoon use, prefer self-feed
Feeding development: 18 to 24 months
Tongue movement refine, cup drinking (internal jaw stability begin), chewing (Mouth closed, rotary movements), transition to harder foods
Feeding development: 24 to 36 months
Improved timing and precision, decreased chewing time, independent self-feeding, increased socialization
Food transitions: 1 month
Only liquids from nipple
Food transitions: 4 to 6 months
Liquids, introduce pureed foods
Food transitions: 8 months
Liquids, pureed foods, ground or junior foods, mashed table foods
Food transitions: 12 months
Liquids, coarsely chopped table foods (including easily chewed meats)
Food transition: 18 months
Liquids, coarsely chopped table foods, most meats, many raw vegetables
Why is it important to know food transitions?
Safety, adequate nutrition, digestive system needs to be ready for different food types, allergies, developmental milestones, texture progression (could identify sensory concerns)
Atypical responses in oral prep and oral phase
Oral/facial tone, tongue retraction, tongue protrusion, reduced spontaneous mouth opening, excessive jaw movement, poor lip seal, oral/tactile sensitivity
Tongue retraction
Atypical response. Tongue goes back down, hard to get child to close mouth around spoon
Treatment for atypical responses in oral prep and oral phase
Tapping and sensory stimulation for increasing tone and activating muscles, food texture changes
Atypical responses in pharyngeal phase
Delayed swallowing response, aspiration before swallow, aspiration during swallow, aspiration after swallow
Delayed swallow response appearance
Not coordinated or purposeful
Aspiration before swallow appearance
(Reduced oral phase) gasp when taking in liquid
Aspiration after swallow appearance
Pooling-material left in mouth, pocketed liquid breathed in
Treatment for atypical responses in pharyngeal phase
Modify texture modify position (chin tuck), modify pace
Atypical responses in esophageal phase
Gastroesphageal reflux, sphincter doesn’t close completely
GERD treatment
Positioning to minimize pressure and improve swallowing
Treatment for atypical responses in esophageal phase
Positioning, surgery, meds, treat for food aversion post GERD
Want to know what about child’s history with food
Allergies, problematic event, g-tube, dinner time behaviors, routines, preferences
Haberman bottle use
For babies, used in absence of suck pattern
Feeding postural alignment
90-90-90, supported feet, stable head (handling on page 409)
Why support feet during feeding?
Utilize weight bearing to build muscle and teach proprioception
Improving oral motor skills
Increase tongue lateralization and rotary jaw movement, increase tongue protrusion and motility, increase lip closure and overall motor stability, coordination of suck-swallow-breath, improve oral strength
Why is tongue protrusion and motility important?
Helps control food/liquid, improves suck-swallow-breathe
Sequential Oral Sensory Approach
-Tolerate the physical presence of the food (Might just be knowing food in the room) -Interact with the food without touch -Tolerate the smell of the food -Touch the food with his or her skin (Not usually on the face) -Place the food in his or her mouth to taste -Not necessarily eating food yet
the child will reject a new food how many times simply on the basis that it is new
10
Food chaining definition
Emphasizes the systematic progression from an accepted food to a novel food by changing one sensory characteristic per presentation.
Food chaining steps
- Expand diet/enjoy foods
- Build on oral motor skills: sequence motor patterns/teach mechanics.
- Techniques: Flavor mapping, transitional foods, flavor masking
Problem feeder
May consume less than 20 foods
Does not add foods to repertoire
Rejects new food and new qualities with extreme emotional response
Consumed foods tend to fall within a texture or food group
Picky eater
Lower range and varieties of foods (20+)
Foods consumed remain in repertoire
Accepts new foods and new qualities of foods at slower rate
Consumes at least one food from most food groups and textures
