Pediatric Feeding Association

Nov, 1 2011

January meeting Will be on January 17th

Sharon Delaney, Becky Carter Infant driven feeding cues

Oral stimulation accelerates the transition from tube to oral feeding in preterm infants Fucile, et al. 2002. Journal of Pediatrics 141: 230-6.

Subjects: Premies born 26-29 wks AGA

Started tx 48 hrs after d/c of NCPAP – tx completed before 34 gest.

Oral treatment – extra and intra oral stimulation with modified Beckman techniques Prior to initiation of oral feeding – 10 consecutive days of tx,

1x/day

Results were: Tx group achieved full oral feeding 7 days earlier than control

group

Discharged slightly earlier

Questions re: study Does research support use of these oral techniques

with NICU graduates in OP settings?

When using oral/sensory techniques what signs can a therapist observe to assess the baby’s response to the technique – positive and negative responses?

Also see:

Fucile, et al. 2011. “Oral and non-oral sensorimotor interventions enhance oral feedingperformance in preterm infants”. Developmental Medicine Child Neurology. 53: 829–835

Marsha Dunn-Klein Blenderized diet book

Work with children with long term feeding tubes

Many books with Suzanne Evans- Morris

Will be doing an evening event on Dec 1 here

7-9pm

Wright Auditorium

Please reach out to your parents who have children on tubes

Xanthum gum Using Bob’s Red Mill powdered XG instead of Simply Thick

ST is being used inappropriately nationwide in NICU’s

Infants too immature

FDA statement – see FDA website

SCH standard

Use XG thickening with infants 44wks or greater

XG only thickener for EBM

Bob’s Red Mill XG – used for gluten free cooking

Available in most supermarkets

Reconstituted it is ok for 2 days in the refrigerator

Policies on thickeners XG is only thickener to be used with ketogenic diet

SCH policy on thickeners

The MODIFIED BARIUM SWALLOW IMPAIRMENT PROFILE: MBSImP Course by Bonnie Martin-Harris , PhD

Alsoweb-based training

MBSimp - has been developed and tested that captures oropharyngeal swallowing impairment. Is an attempt to standardize the VFSS/MBS procedure, report and

way to improve communication /terminology consistency among clinicians.

Wealth of research potential.

Tool can be reliably scored (reliability dependent on training) Web-based environment - provides practical, accessible,

efficient means of training Learner is guided through two levels of learning and practice Competence is assessed in the reliability zone/third level

Currently adult-focused Hoped that a pediatric version will be developed

MBSImP The assessment tool is broken out into 17 Impairment

scores

3 domains (Oral, Pharyngeal, Esophageal Impairment)

Learning Zone: Has VFSS and computer-generated clips of each component and can be viewed in real-time and slow motion.

Includes each level of impairment for each component. Exciting as it has great potential for training, education with family or team members.

Judy Simmons Practical tools New Nuk tooth

zoli toothbursh

Bite and brush Duo spoon – Marsha Dunn Klein Vulli teething toys Curtain rings for teething toys Ark’s oral probes Nylon tricot for chewing bags – nylon tricot netting Nipples – PMSI large base nuk nipples – size 1 & 2 Bustier – for mom’s with poor UE function or very large

breasts that need support during bfeeding

Judy Simmons Book by Diane Barr – “Nobody ever told me or my

mother that”

“Balancing breast and bottle” by Amy Peterson and Mindy Harmer

EE differential – Claire Kane-Miller

Supple Cups – for tx of inverted nipples

Come in different sizes

Most frequently used size is #3 or 4

Straw bottle Hair dye bottle

Use refrigerator tubing – is food grade & different sizes

By in hardware store

Aquarium tubing is not food grade

Amy Faherty NOMAS –

Video with intra bottle camera and influence of flow rate on oral control

NICU scale – early feeding skills assessment

Pre, during and post feeding assessment

NeoNatal Network 2005 24(3):7-16

Maria Cho Food to use during a wean

Sesame paste, instant – can make with water or other liquid

230 cals/packet

Can add pastureized egg product

By at HT market , Ranch 99, other Asian markets

Instructions to make sesame paste After pouring in 5 - 6 oz. of boiling water or milk or non-

dairy milk stir and microwave the mixture in 10-second increments stir each time until it reaches the desired thickness **no more than 30 seconds total microwave time should be

needed, depending upon the potency of the microwave

Potato starch doesn't really thicken unless heated up thoroughly It continues to thicken slightly even after heating – don’t

overheat

If this becomes a staple, add in desired stage 1 jarred baby food, liquid vitamins, iron, or pasteurized egg to vary the nutritional content

Darlene Therapy dog

Ending stories