Peds II: Developmental Milestones

Question 1

Developmental Milestones in Infants and Children related to Normal Swallow

Answer 1

• 0-4 months suckling with rooting reflex predominant; drinks EBM or formula only
• 4-7 months: need to stimulate with purees to ensure development of normal swallow (thin-thick consistencies)

Question 2

How is infant swallow different?

Answer 2

• Oral & Pharyngeal Cavities Smaller
• Tongue size rel. larger with soft palate, pharyngeal wall closer together than in adult (also larynx closer)
• Fat pads in cheeks larger

Question 3

Infant development at 9 months

Answer 3

• Sits/crawls
• Pincer grasp
• Pulls self to standing
• Comprehends “NO”
• Increased interest in pleasing parents
• Food: Thick Puree-soft mashed Foods appropriate texture
• Cannot chew!!! Does not have rotary jaw movements needed for this.
• Finger foods: soft are appropriate (crackers, cheerios etc)

Question 4

Infant development at 12 months

Answer 4

• Walks with assistance
• Follows rapidly moving objects
• Recognizes objects by name
• Turns pages in book
• Food: Table food, Weaning from bottle
• Avoid raw fruits and vegetables re: choking hazards
• Some rotary jaw movments: beginning of ability to chew

Question 5

Infant development at 18 months

Answer 5

• Anterior fontanel closes
• Says 10 or more words
• Temper tantrums may be evident
• Manages spoon without rotation
• May have security objects
• Food: Table food
• Rotary side movement of jaw fully developed; chewing possible

Question 6

Introduction of age appropriate foods

Answer 6

• Introduce one new food at a time
• Most literature suggests iron enriched source of complementary foods: iron enriched cereals, meats & Alternatives
• Delay introduction of egg, milk, soy, peanuts, fish in children with strong family history of food allergy