Transcript
Fantastic Feeders
Jennifer Bekins & Krystin Turner
The Jane and Richard Thomas Center
for Down Syndrome
Introduction to feeding
• Medical status:
– Heart-lung connection
– Gastro-intestinal issues common in DS
Pre-feeding Skills
• Medical status
• Suck: swallow: breathe coordination
• Non-nutritive sucking (sucking without eating)
• Other factors
Setting your child in a position for
success
• What is the best way to feed a baby with DS?
• Considerations
• Options
– Cradle hold
– Semi-reclined
– Upright
– Side-lying
Age vs. Developmental Readiness* for
Feeding
• Turns away or uses vocal protests to indicate
meal-time is over
• Appears interested in what you are eating
• Starting to bring objects to mouth
• Sitting with support
* See visual on developmental stages and oral
feeding
Feeding Readiness:
Transition to Purees
• Skills to look for:
• Head control
• Ways to support
during feeding:
• Recline in space
high chair
• Towel rolls
Bumbo for Infant Feeding? No!
• Do not place on elevated surface
• Must have head control
• Do not use for early feeding for children with
Down syndrome
Spoons!
What to look for in a
spoon:
• Shallow bowl
• Straight handle
• Specialty needed?
– Probably not
How to present the
spoon:
• Straight in
• To side
Spoon Feeding: Front Placement
Used with permission from
http://yomammamamma.blogspot.com/
Spoon Feeding: Side Placement
Used with permission from
http://yomammamamma.blogspot.com/
Spoon Feeding
Video Disabled by Author
for Web Use
Spoon Feeding Techniques
Video Disabled by Author
for Web Use
Influence of Taste and Texture on Oral
Motor Skills
• Taste
• Texture
• Sensory Awareness
Establishing a Mealtime Routine
Transition: Finger Foods
Readiness for Finger Foods
• Sitting with support
• Can pick up items and release with control
(e.g. blocks into bucket)
Readiness for Utensils
• Grasp and release
• Reaching for objects
and bringing to
mouth
• Grading of
movements
Sippys and Cups and Straws, Oh my!
Types of Sippy Cups
Types of Open or Rim Cups
Types of Straw Cups
Readiness for Cup
• Supported sitting
• Grasp and release
• Grading movement
• Lip closure on spoon
• Follow command “Give to me”
Introduction to Open Cup
Video Disabled by Author
for Web Use
Narrow rim cups for open cup practice
Drinking from Recessed Cup
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Straw Drinking
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Transition from Tube to Mouth
• Has oral skills that support oral intake and
swallow safety
• Tolerates tube feeding
Oral Stimulation for Tube Transition
• Importance or mouthing/sucking
• Providing developmentally appropriate items:
– Pacifier, adult finger, teething toy, bottle nipple,
– Spoons, sippy cups, plates, bowls, wet
washcloths, teething toys, the child’s own fingers
Sensory Stimulation
• Smell
• Taste & Touch
• Sucking/Mouthing
• Drinking
• Eating
Oral Aversion Treatment
• Oral stimulation or touching the lips, gums,
teeth, and tongue of your child's mouth
• Giving your child items to place in the mouth
that are not food (non-nutritive)
• Positive reinforcement
• Structured meal times and repetition of a
routine during mealtimes
• Desensitization techniques
Questions?
Contact Information
Jennifer Bekins, MS, CCC-SLP
Jennifer.bekins@cchmc.org
Krystin Turner, MS, OTR/L
Krystin.turner@cchmc.org
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