|Publisher:||Future Horizons, Inc.|
|Product dimensions:||7.90(w) x 9.90(h) x 0.50(d)|
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Crucial Developmental Checklists
What This Book Can Do for You
Parents often receive little instruction on how to feed their children, yet good feeding, eating, and drinking skills encourage the best possible mouth development. You are going to feed your child, so why not use appropriate feeding techniques to support your child's mouth development from birth?
Most of our eating and drinking skills develop in the first 2 years of life. Your child's feeding skills will change rapidly, particularly in the first year. However, many parents don't know the significance of these rapid changes. You can help with the process by using appropriate feeding methods.
Feeding is like dancing. You and your child are partners in this dance. The best feeding method for you and your child may be somewhat different from what others do. As in ballroom dancing, many of the steps are similar, but you will use specific feeding variations to suit you and your child.
This book contains important guidelines to help you and your child learn the feeding dance easily and successfully. It also addresses problems you may encounter in feeding. Some information is repeated in the book for your convenience.
The Importance of Developmental Checklists
We begin with some crucial developmental checklists, so you can discover how your infant or toddler is doing. The checklists are approximate and not absolute. Every baby and toddler has his or her own unique developmental sequence.
If your child is not on track according to the checklists, other sections in the book provide the specific information you need. There are sections on breastfeeding, bottle-feeding, spoon-feeding, cup- and straw-drinking, finger-feeding, taking bites of food, chewing, picky or selective eating, and so on.
Checklists are a good place to begin your journey as they reflect typical development recorded in the literature. You will see where your baby is on track in development. You will also see skills you may want to help him or her develop. The following developmental checklists are found in this chapter of the book:
Feeding and Related Development Checklist: Birth to 24 Months
Food and Liquid Introduction Checklist: Birth to 24 Months
Intentional, Supervised Tummy/Belly Time to Creeping/Crawling Checklist: A Likely Fundamental Missing Developmental Link (Birth to 7 Months)
Mouth and Hand-Mouth Reflex or Response Checklists
Feeding and Related Development Checklist: Birth-24 Months
This checklist is a guide to help you gauge if your child is on track in feeding development. The details presented in these lists are available to therapists, but most parents and pediatricians don't have the benefit of this literature-based, criterion-referenced information. Many resources were used to create these checklists. A special thank-you goes to Suzanne Evans Morris, who supplied the only known longitudinal study on typical feeding development. She and Marsha Dunn Klein wrote Pre-Feeding Skills: A Comprehensive Resource for Mealtime Development (2nd ed.), which continues to be a primary reference for feeding specialists and was a vital resource for this book.
If you have questions concerning your child's feeding development, please discuss these with your child's pediatrician and appropriate other professionals as needed.
Place a check mark next to the characteristics you see in your baby at birth.
At birth, your baby's mouth and throat structures are close together to protect him or her from choking when feeding. Feeding readiness is based on the coordination of sucking, swallowing, and breathing. If feeding well, your baby's tongue will cup the breast or bottle nipple (not hump or bunch). Her gums may enlarge to assist with the latch. This is likely related to increased blood supply to the gums. Her lips will latch on the bottle nipple or breast. She will suck approximately 1 time per second (nutritive suck) but may lose some liquid from her mouth when feeding. If she suckles faster, such as 2 times per second, she may not be getting milk (non-nutritive suckle).
Full-term, typically developing babies (40 weeks gestation) usually have the innate ability to breastfeed (unless there is a tongue tie or other problem at birth). In my opinion, babies should be checked for reflexes, sucking pads, nose-breathing, and tethered oral tissues (particularly tongue ties) at birth.
When babies are placed on the mom's abdomen right after birth, they usually crawl to the breast and begin feeding. The umbilical cord may be attached and pulsing for a period of time after birth. Breastfeeding is biologically normal, and the best way to feed a baby for the most ideal health and development. The laid-back breastfeeding position seems to be the most natural. If you wish to breastfeed, work with an International Board-Certified Lactation Consultant (IBCLC) and feeding specialist if needed.
Babies who are close to term (37 to 39 weeks) or premature can also learn to breastfeed with appropriate help. Sucking or fat pads develop in a baby's cheeks toward the end of a full-term pregnancy. These provide the side-stability in the mouth needed particularly for breastfeeding. Many babies who are close to term do not have adequate sucking pads. Babies born prematurely usually do not have sucking pads. Accommodations for this problem, such as carefully applied cheek support, are covered in this book.
Unfortunately, many families are encouraged to bottle-feed their babies, particularly if the baby does not immediately breastfeed at birth. Bottle-feeding is an unnatural, medical way of feeding a baby. It's a very different process from breastfeeding. If you are bottle-feeding, be sure your baby's ear is above her mouth as you hold her body upright at a 45+ degree angle to the horizon (not lying down). This will help keep liquid from going into her Eustachian tubes and middle ears, which may cause ear problems. Paced (baby-led) bottle-feeding is recommended. Please read the breastfeeding and bottle-feeding sections in this book.
Your baby will mouth her hands and fingers near the front of her mouth (generalized mouthing). When your baby is not feeding, sucking on fingers and/or hands, or making vocal sounds, her mouth should be closed. Then her tongue can rest in the roof of her mouth to help maintain a typical broad palate shape. She will be nose-breathing, which is crucial for good health. Mouth-breathing, on the other hand, is extremely unhealthy. Proper breastfeeding also assists in maintaining the palate's shape.
Additionally, your baby's mouth should be free of tethered oral tissues, such as tongue tie. If your baby's tongue is tied, it cannot rest in the roof of the mouth to help maintain the palate's broad shape. This often results in high and narrow mouth roof, which makes the nasal area small and impacts healthy nasal breathing.
Your baby also needs a good amount of supervised, intentional tummy or belly time, as well as other body positions, to ensure adequate and on-time development of sensory-motor skills. The development of postural control in the body is the foundation for movement. It leads to rolling, sitting, and the refined skills your child will eventually develop in the mouth, eyes, and hands (eating, drinking, babbling, vision use, self-feeding, etc.).
At birth, your baby will have full-body reflexes, in addition to 3 hand-mouth reflexes and 7 mouth (or oral) reflexes. Your child's pediatrician or other appropriate professionals can check these. All of the reflexes are important for the development of postural (or body) control and feeding.
The 3 hand-mouth reflexes are the palmomental, Babkin, and grasp. These reflexes help your baby's hands and mouth work together during feeding. The 7 mouth (or oral) reflexes are rooting, suckling, tongue extrusion, swallowing, phasic bite, transverse tongue, and gag. These reflexes assist with feeding. At birth, your baby's gag response will be found on the back 3/4 of her tongue to protect her from ingesting items too large to swallow. You have a chart on the 7 mouth reflexes and 3 hand-mouth reflexes for your reference near the end of this chapter.
By 1 month of age, your baby can locate the breast or bottle nipple easily with his or her mouth. The rooting reflex is coming under control. You will see the rooting reflex more often in breastfed than bottle-fed babies unless paced (baby-led) bottle-feeding is used. Breastfed babies use the rooting reflex to find the mother's nipple. Bottle-fed babies often have the nipple placed into their mouths and don't really use the reflex unless the parent is using suggested and preferred paced (baby-led) bottle-feeding. Your baby can now suck breast milk or formula sequencing 2 (or usually more) sucks at a time with good suck-swallow-breathe coordination but may still lose some liquid from the mouth.
Your baby's mouth, nose, and throat areas continue to grow and change. He will mouth his hands and fingers near front of the mouth (generalized mouthing). He should have easy nose-breathing, and his mouth should be closed during sleep and when his mouth is inactive (not feeding, mouthing hands, or making vocal sounds). His tongue should rest in the roof of his mouth to help maintain the broad palate shape. A pacifier or bottle nipple cannot do this, but proper breastfeeding can help keep the palate shape. His mouth should also be free of tethered oral tissues, such as tongue tie.
Additionally, your baby requires a good amount of intentional, supervised tummy or belly time, as well as other body positions, to ensure adequate and on-time development of sensory-motor skills. This creates the foundation for the postural control required for feeding and ultimately speaking. Your baby can imitate some mouth movement (open mouth, tongue out) and can match the pitch and duration of your voice. These are likely the mirror neurons at work, which allow your baby to mirror what you do.
By 2 to 3 months of age, your baby is developing control of the suckling reflex. He or she will suck for longer periods of time without pausing. The mouth is beginning to change shape, and the tongue is beginning to move with increasing purpose within the mouth. You will also see your baby bring her hands together when feeding. She may rest them on the breast or bottle. Around 2 months of age, your baby will bring her hands to her mouth when she is on her belly, and around 3 months of age, she will bring her hands to her mouth when she is on her back. This process is called generalized mouthing because your baby is mouthing or sucking on her hands at the front of her mouth. Your baby also did this in utero.
Babies with difficulty breastfeeding or bottle-feeding often improve significantly by 6 to 8 weeks of age as their suck-swallow-breathe coordination increases. You may need to work with your International Board-Certified Lactation Consultant and/or a feeding therapist to arrive at this point. Feeding therapists are usually speech-language pathologists or occupational therapists who specialize in feeding.
Your baby's mouth, nose, and throat areas continue to grow and change. She should have easy nose-breathing, and her mouth should be closed during sleep and when her mouth is inactive (not feeding, mouthing hands, or making vocal sounds). Her tongue should rest in the roof of the mouth to help maintain the palate shape. A pacifier or bottle nipple cannot do this, but proper breastfeeding can help keep the broad palate shape. Her mouth should be free of tethered oral tissues, such as tongue tie.
Additionally, your baby requires a good amount of intentional, supervised tummy or belly time as well as other body positions to ensure adequate and on-time development of sensory-motor skills. Good postural control is the foundation on which refined motor skills like feeding and ultimately speaking are developed. Your baby may follow your movements with her eyes and vocalize. This, again, may be her mirror neurons in her brain at work. Mirror neurons are those which allow your baby to copy what you do.
Development (3 to 6 months)
A lot of changes are happening in your baby's structures and feeding abilities between 3 and 6 months of age. You will see his or her tongue extrusion and Babkin reflexes fade at 3 to 4 months of age. You will also see less of his rooting reflex at 3 to 6 months. These reflexes seem to be disappearing, but reflexes do not really disappear. The movement area of your baby's brain is developing and taking control, so the reflex is not needed. Therefore, your baby may locate the breast without rooting. The third lips (the slight gum swelling during feeding that seemed to help with the breast or bottle latch) will also seem to disappear.
Between 4 and 6 months of age, the gag reflex will be stimulated further back on your baby's tongue. New mouthing and feeding experiences allow this to occur. Your baby will mouth and chew on appropriate toys such as Beckman TriChews by ARK Therapeutic, a Baby Grabber by ARK Therapeutic, Chewy Tubes' Baby Mouth Toys, or other appropriate baby mouth toys made from approved materials.
Breastfed babies have a particular advantage when it comes to the integration of the gag reflex. If your baby is breastfeeding properly, the breast is drawn deeply into your baby's mouth, which helps the gag become located further back on the tongue. As your baby gains control over his mouth space and movement, the gag reflex does not need to occur as far forward on the tongue. However, it will still help protect your baby from items too large to swallow. Of course, you will be careful to give your baby appropriately sized mouth toys and foods when you introduce them.
Mirror neurons (where your baby mirrors what you do) play a crucial role in feeding and other activities. Therefore, it's essential to be a good role model for your baby, beginning at birth. This includes the movements you make, what you say, and your social interactions. When you give foods and liquids to your baby (beginning around 6 months), it's very important you eat and drink along with him as much as possible. Your baby understands more than you think, so you will want to be a good role model as you talk and socialize with him. You are helping him set down life-long eating, drinking, and interaction patterns.
Between 5 and 9 months of age, your baby will explore appropriate toys and his own fingers throughout his mouth. He may use his mouth like a third hand for this exploration. This leads to good oral discrimination needed for eating, drinking, and ultimately speaking. According to Suzanne Evans Morris and Marsha Dunn Klein, the mouth and hands have the most sensory receptors per square inch in the human body.
Additionally, your baby's phasic bite reflex comes under control with proper biting and chewing experiences between 5 and 9 months. Around 6 months of age, your baby's teeth may begin to come in as he has appropriate biting and chewing experiences. The processes of taking bites and chewing help develop the jaw, lips, cheeks, and tongue muscles, as well as assist in the appearance of teeth. In my experience, babies who don't chew and bite on suitable toys and foods are often late in tooth development and have increased jaw, lip, cheek, and tongue problems.
During the 3- to 6-month period, the space within your baby's mouth, throat, and nasal areas increases. Your baby's palate (mouth roof), nasal, sinus, and throat areas are developing. There is expanding open space in your baby's mouth because his skull and jaw are growing and his sucking pads are getting smaller (between 4 and 6 months). Additionally, your baby will have increasing lip and cheek control and movement. Lips and cheeks work together in feeding and in speech.
Your baby's mouth structures are learning to move independently of one another over time. For example, the tongue, lips, and cheeks begin moving independently of the jaw. Therapists call this dissociation. This process allows valving within the mouth where appropriate mouth structures come together and move apart like the closing and opening of a valve.
Through this valving, your baby will learn to control the pressure changes within his mouth. Therapists call this intraoral pressure. The mouth, throat, esophagus, voice box, and respiratory system are really systems with valves and pressure changes. You will also see your baby move his mouth just enough for the activity in which he is engaged. Therapists call this grading of movement. The processes of dissociation, grading, and valving allow the development of mature eating, drinking, and ultimately speaking skills.
As your baby's mouth, nose, and throat areas continue to grow and change, he should have easy nose-breathing. His mouth should be closed during sleep and when his mouth is inactive or quiet (not feeding, mouthing hands or toys, or making vocal sounds). His tongue should rest in the roof of his mouth to help maintain the broad palate shape. His mouth should be free of tethered oral tissues, such as tongue tie. He also requires a good amount of intentional, supervised tummy or belly time, as well as other body positions to create the foundation for the postural control required for all body movement, including feeding and vocal development.(Continues…)
Excerpted from "Feed Your Baby & Toddler Right"
Copyright © 2018 Diane Bahr, MS, CCC-SLP.
Excerpted by permission of Future Horizons, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
CRUCIAL DEVELOPMENTAL CHECKLISTS:
SECRETS FOR BETTER BREAST AND BOTTLE FEEDING