quiz 2

Question 1

1. When oral feed are first recommended

Answer 1

 Oral feeds not recommended until infants reach 32-33 weeks gestation
 Attempts can be successful short term but may become counterproductive
 May burn more calories than they ingest

Question 2

2. Difference between nutritive and non nutritive sucking (one difference)

Answer 2

• NS: Sucking on a bottle or a breast nipple for nutrition typically 1 suck per second
• NNS: Sucking for reasons other than nutrition (pleasure, calming → pacifier), 2 sucks per second, faster rate than NS, does not guarantee NS

Question 3

3. Why some would refer a child to SLP for clinical feeding evaluation

Answer 3

o Sucking and swallowing incoordination
o Weak suck
o Breathing disruptions or apnea during feeding
o Excessive gagging
o New onset of feeding difficulty
o Diagnosis of disorders associated with dysphagia /under nutrition
o Weight loss or lack of weight gain for 2 to 3 months
o Severe irritability or behavior problems during feeds
o History of current pneumonia and feeding difficulty
o Concern for possible aspiration during feeds
o Lethargy or decreased arousal during feeds
o Feeding periods longer than 30 to 40 mins
o Unexplained food refusal and under nutrition
o Drooling persisting beyond 5 years
o Nasopharyngeal reflux with feeding
o Delay in feeding developmental milestones
o Children with craniofacial abnormalities

Question 4

4. What is the most ideal sleep ideal level (only one)

Answer 4

Quiet alert- best state for learning to occur; infant is focusing all attention on visual, auditory, tactile and sucking stimuli

Question 5

5. Three signs of stress to look for during a feeding evaluation

Answer 5

•	Color changes
•	Decrease in O2 (90%)
•	Increased work of breathing RR>65
•	Tachypnea 120-180
•	Extended limbs
•	Flaccidity of trunk/face/extremities
•	Arching
•	Change of alertness
•	Irritability
•	Panicked or worried look
•	Nasal flaring
•	Gulping
•	Wet gurgle sound 
although this IS NOT always pres

Question 6

6. Five components involving central alignment.

Answer 6

• Neutral head flexion
• Neck elongated
• Shoulder girdle stable and depressed
• Trunk elongated
• Pelvis stable and symmetrical in neutral position
• Hips at 90
• Feet in neutral with slight dorsiflexion

Question 7

7. what you want to promote by giving good positioning

Answer 7

coordination of the body and mouth for effective oral sensorimotor and feeding activities. Adjustments are made to attain neutral head, neck and trunk position –> straight line

Question 8

8. Cerebral palsy indicators

Answer 8

• Lack of alertness
• General irritability or fussiness
• Jitteriness or trembling of arms and legs
• Abnormal high-pitched cry
• Apnea
• Bradycardia
• Poor feeding abilities
• Low muscle tone
• Seizures

Question 9

9. Population likely to be encountered in NICU

Answer 9

o	Anemia
o	Apnea
o	Prematurity
o	Brain bleeds/cerebral palsy
o	Cardiothoracic problems
o	Various syndromes 
o	Respiratory Distress/ pulmonary problems
o	GI problems (ie NEC)
o	Cleft lip/palate
o	Jaundice
o	Meconium Aspiration