Feeding

Question 1

Name the 5 ways that OT’s work in feeding

Answer 1

1. oral aversion
2. tube to oral transition
3. poor oral motor skills
4. poor hand to mouth coordination
5. Work with nutritionists, GI and psychologists for poor weight gain, nutrition and psychological factors impacting feeding

Question 2

What are the four phases of swallowing?

Answer 2

1. Oral Preparatory
2. Oral Phase
3. Pharyngeal
4. Esophageal

Question 3

What phase of swallowing does this describe?
tongue lifts bolus up and posterior to propel it back into the pharynx; soft palate lifts and retracts to close off the nasal passage; this phase ends when the bolus has left the mouth; voluntary control

Answer 3

Phase 2: Oral Phase

Question 4

What phase of swallowing does this describe?
food is introduced into the mouth; the lips close; the tongue, teeth, and cheeks break down the food; a bolus or mass is formed; voluntary control

Answer 4

Phase 1: Oral preparatory

Question 5

What phase of swallowing does this describe?
begins as food enters the pharynx; food moves down pharynx through contraction of pharyngeal muscles; swallow shifts from voluntary to involuntary control; this phase is when aspiration can occur; hyolaryngeal excursion is the key

Answer 5

Phase 3: Pharyngeal Phase

Question 6

What phase of swallowing does this describe?
begins as food enters the upper esophageal sphincter; bolus travels through esophagus to lower esophageal sphincter; bolus enters stomach; this phase is where GERD occurs; this phase is also involuntary

Answer 6

Phase 4: Esophageal Phase

Question 7

How do OT’s treat phase 4?

Answer 7

Clinical observations of problems

Question 8

How do OT’s treat phase 3?

Answer 8

Clinical observations of problems; thicken liquids

Question 9

How do OT’s treat phase 1?

Answer 9

1. oral and motor warm ups; positioning; assessing hunger and environment
2. improving hand to mouth coordination
3. improving quality and speed of chewing through lip closure, increasing lip strength, cheek strength, jaw strength, and tongue strength
4. Sensory issues - see it, touch it, smell it, kiss it
5. Behavior program - big plate/small plate

Question 10

How do OT’s treat phase 2?

Answer 10

Treat Phase 1 - what is the problem with propelling food backwards?

• tongue strength or retraction
• poor bolus formation, pocketing
• poor coordination of musculature
• poor pressure
• poor speed for propulsion

Question 11

T/F: Rhythm is the most consistent characteristic of feeding patterns during the first 3 months of life

Answer 11

true

Question 12

T/F: Everyone needs a consistent sleep/wake/eat/poop cycle

Answer 12

true (lol)

Question 13

T/F: All nipples have the same flow rate

Answer 13

False

Question 14

What is non-nutritive sucking?

Answer 14

sucking on something that doesn’t feed the baby; calming, improves organization; helps transition to oral feedings; facilitates digestion for tube feeders; wean pacifier at one year

Question 15

What age group does this describe?
8oz every 3-4 hours; toys in mouth for exploration; moves gag reflex back; stimulates transverse tongue reflex for tongue laterization; many babies transition from breast feeding to bottle feeding at this time

Answer 15

3-6 month infant

Question 16

What age group does this describe?
Suckling is replaced by sucking; AAP recommends starting solid foods (baby food); able to sit upright supported and have good head control

Answer 16

6 month infant

Question 17

What age group does this describe?
spoon use; wait for mouth to open before giving spoon; don’t mix food flavors together; give dissolvable foods first for finger foods; these babies can’t move food from the center to the side or transfer from side to side yet

Answer 17

6 month infant

Question 18

When does the phasic bite occur?

Answer 18

birth to 3-5 months

Question 19

When does munching occur?

Answer 19

6 months

Question 20

When does tongue laterization emerge?

Answer 20

6 months

Question 21

When does vertical chewing emerge?

Answer 21

12 months

Question 22

When does diagonal/lateral chewing emerge?

Answer 22

18 months

Question 23

When does circular rotary chewing emerge?

Answer 23

18-36 months

Question 24

Baby is beginning to drink from an open cup with support and able to hold a cookie and bring to mouth to take a bite

Answer 24

9-12 months

Question 25

Why is tongue retraction with laterization so important?

Answer 25

food will get stuck; need the laterization to chew; need tongue retraction to properly drink from a straw; every sound in the english language requires tongue retraction except “th”

Question 26

What age does this describe?
no more drooling; chewing with lips closed; transition sippy cups to straw cups; lateral/diagonal chew emerges; able to use spoon and drink from an open cup with minimal spillage

Answer 26

18 months

Question 27

T/F: children eat a different caloric intake each day so that is why they may eat a different amount of food each day

Answer 27

False- children eat the same caloric intake each day; if they eat more calorie dense food, they will eat less that day.

Question 28

T/F: children will starve themselves

Answer 28

true

Question 29

T/F: its ok to play with your food

Answer 29

true

Question 30

T/F: eating is a learned behavior; you lose your primitive motor reflex to eat after 4-6 weeks

Answer 30

true

Question 31

T/F: Iron and zinc deficiencies decrease appetite

Answer 31

true

Question 32

T/F: stress decreases appetite

Answer 32

true