PEDS Flashcards
Pharyngeal swallowing seen
10-12.5 weeks
True suckling seen
18-24 weeks
Efficient swallow seen
36+ weeks
Most often diagnosis that leads to a swallowing problem
Prematurity
Baby is considered premature when born before
37 weeks
Premature babies oral/pharyngeal characteristics
smaller, less stable structures
T/f: premature babies have low muscle tone, flaccid or floppy
True
T/f: sucking pads are not present or fully developed in very premature or very low birth weight babies
True
Premature babies/Very Low Birth Weight babies and respiration:
difficulty coordinating the “suck-swallow-breathe” pattern
T/f: premature babies have overall physiological instability and co-morbid diagnoses
True
3 differences btw infants and adult anatomy
in infants: the tongue sits forward and fills the oral cavity, mandible is small and slightly retracted, epiglottis is higher in the neck, soft palate touched top of epiglottis at rest, Larynx is “funnel shaped”, trachea is shorter and more narrow. In adults: tongue begins to drop + move posteriorly, mandible grows allowing for the tongue to sit, epiglottis flattens and lowers in the neck, soft palate does not touch epiglottis while at rest, larynx straightens and becomes “column shaped”, trachea is wider and longer
Two types of sucking patterns in babies
non-nutritive (faster/rapid); nutritive (slower)
4 newborn reflexes
rooting reflex, suckling reflex, tongue protrusion reflex, grasping reflex
By 4-6 months this newborn reflex will disappear, allowing for spoon feeding:
tongue protrusion
What newborn reflex allows for liquid intake
Suckling reflex
What newborn reflex prepares the baby for self-feeding, holding bottles, and picking up food
Grasping reflex
T/f: feeding and swallowing development changes rapidly from birth to approximately 5-6 years old
True
t/f: there is a difference between a feeding disorder and a swallowing disorder when discussing peds
True
examples of a feeding disorder in babies:
oral aversion, restricted diet “picky eater”, texture preferences, food preferences, behavioral component
examples of a swallowing disorder in babies:
anatomical or physiological component (cleft palate, esophageal atresia), neurological component (VF paralysis, cerebral palsy, hypo/hypertonia), difficulty coordinating suck/sip-swallow-breathe
difficulty coordinating suck/sip-swallow-breathe is a problem with feeding or swallowing?
Swallowing
Name distress cues in infants
crying, coughing, gagging, back arching, turning head away from food presentation, push bottle away, prolonged feeding, falling asleep during feeding
Name distress cues in older children
crying, coughing/gagging, turning head away from food presentation, pushing food away, prolonged feeding, food pocketing, falling asleep during feeding, difficulty chewing or maintaining food in mouth while eating, refusing certain textures or types of food, verbally saying “No, I don’t’ want that, yuck”
Possible medically critical concerns distress cues
coughing/choking during mealtime, frequent congestion - particularly after mealtime, respiratory illness (frequency), fever post-feeding, wet or noisy vocal quality during or after feeding, vomiting or reflux that is recurrent
