Feeding Problems

Question 1

what is the function of feeding and swallowing

Answer 1

• satisfies hunger
• reflexive sucking
• sensory and motor stimulation
• mother/caregiver-infant bonding
• oral motor skill development

Question 2

T/F: for normal infant a&p structures are smaller and further in proximity

Answer 2

False; structures are smaller and CLOSER in proximity

Question 3

what are the characteristics for normal infant a&p

Answer 3

• ideal for sucking (large tongue, large buccal pads, no teeth)
• close approximation of tongue, soft palate, pharyngeal wall
• high larynx adjacent to C1-C3
• epiglottis tubular, narrow

Question 4

What are the S/S of pediatric dysphagia

Answer 4

• poor oral suction
• inadequate volume of intake (not able to suck and w/o adaptive equipment not able to get nutrition)
• lengthy feeding times
• nasal regurgitation (common through cleft palate or VPI)
• excessive air intake- spit up/bloating/crying/gassy
• coughing
• choking
• poor weight gain (b/c aspirating versus going into stomach and getting nutrition)
• excessive energy expenditure (fatigue b/c of lengthy feeding tie trying too hard and using more effort)
• discomfort during feeding (common, related to excessive air)
• stressful feeding (caretaker and infant) *if stressful its a problem

Question 5

what is the physiology of the oral phase in infant feeding

Answer 5

• sucking to stabilize nipple, create negative pressure gradient for fluid flow, control bolus before swallow
• rooting reflux (helpful to grasp on nipple
• nipple compression
• negative pressure

Question 6

what is the physiology of the pharyngeal phase in infant feeding

Answer 6

coordination of nasal breathing sucking and swallowing

Question 7

what is the physiology of the esophageal phase in infant feeding

Answer 7

UES and LES

Question 8

T/F: breathing thru nose when feeding should be 2:1

Answer 8

False: it should be 1:1

Question 9

how can you assess airway protection during feeding in infants

Answer 9

• MBSS (used more often and easier with infant)

- FEES

Question 10

what are general feeding modifications

Answer 10

• relax and comfort mom
• proper feeding equipment and methods
• upright positioning
• be consistent with feeding method
• manage air intake
• limit feeding to 30-45 minutes

Question 11

Why would you need upright positioning during feeding

Answer 11

-because you need gravity to help

Question 12

why would you limit feedings to 30-45 minutes

Answer 12

-to avoid fatigue/aggravation

Question 13

what are proper feeding equipment and methods

Answer 13

• assistive squeezing (hand expressing breast milk) *with cleft kids it doesn’t often work
• breaks to rest or burp (every ounce or so to manage air intake)
• adaptive nipple/bottles (slower/faster flow rate (hole/slit), pliability, shape and size)