pediatrics Flashcards
aversion (to what?)
touch, taste, temp, textures, smell, sight
aversion (where?)
localized to mouth/face OR global sensory problem
aversion responses
cry, grimace, wiggle, arch away, shutting down/sleeping
diagnoses at risk for oral motor feeding problems
broncho-pulmonary disease (poor SSB) cardiac disorders (rapid fatigue) drug/alcohol exposure genetic disorders GI issues (reflux) neurological impairment (TBI)
SSB synchrony: when are structures present?
3.5 weeks gestation
SSB synchrony: when does swallow first occur?
14-17 weeks gestation
SSB synchrony: When does SSB emerge?
31-33 weeks
SSB synchrony: When does SSB mature?
37-38 weeks
stress cues (behavioral)
shut down/sleep decreased interest/distraction while feeding stop sign hand/finger display push bottle away tongue on roof of mouth
stress cues (non-behavioral)
facial changes
fatigue
changes in tone and respiratory rate
0-3 months
chin to rib cage jaw, tongue, cheeks, lips work as 1 unit tongue: large, fills oral cavity reflexes: gag, rooting, phasic bite (down), suck-swallow sucking pads
sucking pads
develop last 2 weeks in utero
fatty tissue pads surrounded by inactive cheek muscles
provide stability/support to help tongue compress nipple
3-6 months
problems because changing anatomically (more airflow)
head control increasing
muscles around face/cheeks develop
sucking pads gone (6 months)
everything elongates: neck, larynx lower in throat
6-9 months
NECK/SHOULDERS more stable
strong active SUCK (no longer reflexive)
graded JAW movement (open half way)
12-18 months
refining movements
rotary CHEW begins
active LIPS clean spoon and lower lip
24 months
TONGUE becomes major cleaner inside/outside mouth (before: cloth)
easy LIP closure with no liquid loss from cup
controlled BITE
4-5 years
oral motor feeding skills/coordination fully established
GER signs in peds
coughing/choking during feeding re-swallows/dry swallows arch back irritable, cranky, moody eats small amounts (limits self) wet burps turns head to left during/after feeding (pathway of esophagus around aortic arch) ear infections
non-nutritive suck rate
~2 sucks/second
non-nutritive suck at 27-28 weeks
weak single suck with long pauses
non-nutritive suck at 30-33 weeks
short sucking bursts with long irregular pauses
nutritive suck rate
~1 suck/second
4 components of a nutritive suck
expression
suction
cheeks/lips not active but help with stability
tongue/palate “seal” drives swallow
rate of sucks/burst at 38 weeks
12-18 sucks/burst
fully mature pattern of SSB
20-30 sucks/burst
44 weeks gestation (4-6 weeks past full term) that brain receptors fully mature and send message to brain to do what?
breathe
