Peds feeding

Question 1

Oral Structure Development New Born

Answer 1

Small oral cavity Filled with Fat pads (inside the checks/tongue) Allows for grasp compression of nipple and automatic suction Full-term healthy baby can breast or bottle-feed (Suck swallow breath pattern)

Question 2

When do the fat pads go away

Answer 2

4 months

Question 3

Oral Structure Development infant

Answer 3

Structures are close together Epiglottis and soft palate are in direct approximation Nipple liquid can pass safely from base of tongue to esophagus Larynx + epiglottis falls over to protect trachea makes aspiration less likely before 4 months

Question 4

Oral Structure Development 12 months

Answer 4

Hyoid, epiglottis, larynx descend (creates space between structures and base of tongue) Hyoid and Larynx become mobile during swallowing (elevate) More complex suck-swallow-breathe sequence = greater coordination Elongated pharynx increases aspiration risk when feeding in reclined position

Question 5

Infant growth

Answer 5

Neck elongates Oral cavity larger and more open (allows greater control tongue, lips, + cheeks) Tongue thinner and more muscular Cheeks lose much of fatty padding New sucking patterns (can handling liquid w/o previous infant structure
Up down movements (liquid from nipple Rotary tongue (chewing)

Question 6

At 1 month what is the sequence of eating

Answer 6

<p>Liquids only suckling/sucking pattern tongue extension-retraction to swallow no biting chewing</p>

Question 7

3 months what is the sequence of eating

Answer 7

<p>liquid pureed suckling/sucking primitive suckle pattern tongue moves extension-retraction 20+ sucks from breast/ biting chewing rare- may show reflexive biting</p>

Question 8

5 months what is the sequence of eating

Answer 8

eat pureed foods formula or breast milk primary nutrition continues sucking pattern tongue up and down one sip at a time from cup held by caregiver primitive phasic bite- and- release pattern biting isn’t controlled or sustained

Question 9

6 months what is the sequence of eating

Answer 9

Pureed and lumpier textures not losing liquids during sucking (unless from cup) tongue up down bottle but extension retraction w/cup variable jaw movements diagonal rotary movement when moving the tongue to the side Some tongue lateralization when food is placed on the side Lips assist hold food in place for chewing

Question 10

9 months what is the sequence of eating

Answer 10

Soft foods mashed table foods Strong sucking pattern without liquid loss
Long sequence of sucking when drinking from a cup (one-three sucks before stopping to swallow or breathe Munches w/diagonal movements as food is transferred from center to sides Voluntary food object biting Lips are active w/jaw during chewing Lateral movements used to transfer food from the center to the side of the mouth

Question 11

12 months what is the sequence of eating

Answer 11

Easily chews food including meats and coarsely chopped foods
Most liquid from cup may still lose Uses sucking up and down movement
Swallows w/tongue tip elevation (liquids and semisolids At time tongue protrusion
Closed lip during swallow Controlled sustained bite w/soft cookie Begin rotary chewing movements Lips are active during chewing Transfer food from the center to both sides w/ease

Question 12

18 months what is the sequence of eating

Answer 12

Coarsely chopped foods including meats and raw vegetables
Mature sucking pattern Jaw is stable when drinking from a cup Uses tongue tip elevation w/swallowing Swallows solid food with easy lip closure No loss of food Controlled sustained bite on hard cookie Demonstrates rotary chewing

Question 13

24 months what is the sequence of eating

Answer 13

Eats all foods except skin very tough meats or foods that break into larger pieces Adult like sucking patterns up and down tongue movement
No liquid loss Swallow solids easily w/lip closure Tongue tip elevation Transfers food booth sides of the mouth when chewing Circular rotary movements when transferring food across midline from one side to the other

Question 14

feeding performance seen at 5-7 months

Answer 14

Takes cereal or purred baby food from spoon

Question 15

feeding performance seen at 6-8

Answer 15

Attempts to hold bottle but may not retrieve if it falls Needs to be monitored for safety

Question 16

feeding performance seen at 6-9

Answer 16

Holds and tries to eat cracker but sucks more than biting Eats soft food that dissolves in mouth Grabs at spoon but bangs it or sucks on either end

Question 17

feeding performance seen at 9-13

Answer 17

Self-finger feed a portion of meals consisting of soft table foods mac, peas, dry cereal

Question 18

feeding performance seen at 12-14

Answer 18

Dips spoon in food Bring spoonful of food to mouth Spills food by inverting spoon before it goes into mouth

Question 19

feeding performance seen at 15-18

Answer 19

Scoops food w spoon and brings it to mouth

Question 20

feeding performance seen at 24-30

Answer 20

Demonstrates interest in using fork May stab at food Proficient at spoon use Eats cereal w/milk or rice w/gravy w/utensil

Question 21

Fluid consistencies

Answer 21

Thin-Water, juice, broth
Nectar Tomato juice, yogurt smoothie
Honey Slowly drips off spoon
Pudding eaten with spoon holds shape

Question 22

Food consistencies

Answer 22

Whole Cup it Chopped Ground Pureed

Question 23

Thin-Water,

Answer 23

juice, broth

Question 24

Nectar Tomato

Answer 24

juice, yogurt smoothie

Question 25

Honey

Answer 25

Slowly drips off spoon

Question 26

Pudding

Answer 26

eaten with spoon holds shape

Question 27

Soft foods mashed table foods Strong sucking pattern without liquid loss

Answer 27

9 months

Question 28

Long sequence of sucking when drinking from a cup (one-three sucks before stopping to swallow or breathe

Answer 28

9 months

Question 29

Munches w/diagonal movements as food is transferred from center to sides Voluntary food object biting

Answer 29

9 months

Question 30

Lips are active w/jaw during chewing

Answer 30

9 months

Question 31

Lateral movements used to transfer food from the center to the side of the mouth

Answer 31

9 months

Question 32

Eats all foods except skin very tough meats or foods that break into larger pieces

Answer 32

24 months

Question 33

Adult like sucking patterns up and down tongue movement No liquid loss Swallow solids easily w/lip closure Tongue tip elevation

Answer 33

24 months

Question 34

Transfers food booth sides of the mouth when chewing Circular rotary movements when transferring food across midline from one side to the other

Answer 34

24 months

Question 35

Easily chews food including meats and coarsely chopped foods

Answer 35

12 months

Question 36

Most liquid from cup may still lose Uses sucking up and down movement

Answer 36

12 months

Question 37

Swallows w/tongue tip elevation (liquids and semisolids At time tongue protrusion Closed lip during swallow

Answer 37

12 months

Question 38

Controlled sustained bite w/soft cookie Begin rotary chewing movements Lips are active during chewing Transfer food from the center to both sides w/ease

Answer 38

12 months

Question 39

Coarsely chopped foods including meats and raw vegetables

Answer 39

18 months

Question 40

Mature sucking pattern Jaw is stable when drinking from a cup Uses tongue tip elevation w/swallowing

Answer 40

18 months

Question 41

Swallows solid food with easy lip closure No loss of food Controlled sustained bite on hard cookie Demonstrates rotary chewing

Answer 41

18 months

Question 42

Pureed and lumpier textures

Answer 42

6 months

Question 43

not losing liquids during sucking (unless from cup)

Answer 43

6 months

Question 44

tongue up down bottle but extension retraction w/cup

Answer 44

6 months

Question 45

variable jaw movements diagonal rotary movement when moving the tongue to the side

Answer 45

6 months

Question 46

Some tongue lateralization when food is placed on the side Lips assist hold food in place for chewing

Answer 46

6 months