1) Sucking and swallowing for low birth weight and preterm babies: Summary of symptoms
- Low sucking pressure and unstable sucking and swallowing
- Intermittent sucking
- High risk of aspiration because of immature coordination between swallowing and breathing movements.
Ways of treatment:
- Because the coordination of sucking, swallowing and breathing movements would be matured around 35 weeks of gestational age, it is important to nurse the babies carefully.
- Practice the babies to latch on their own mothers' nipples with kangaroo care
- Give the babies gentle massages outside and inside of their mouths to become habituated to the stimulus of sucking and swallowing.
- Press gently the babies cheeks on the both sides to practice them to generate negative pressure in their oral cavity.
2) Sucking and swallowing for babies with a cleft lip/cleft palate: Summary of symptoms
- Difficulties of sucking because of disfunctions of generating negative pressure and compressing nipple in the oral cavity
- Risk of backward flow of breastmilk or formula through the nasal cavity of babies
- Risk of aerophagia
- Shortage of milk intake with taking excessive time of sucking
Ways of treatment:
- Breastfeed or bottle-feed with much care of aspiration and backward flow of milk through nasal cavity
- Take appropriate position during breastfeeding or bottle-feeding
- For babies with cleft lips, make sure of shielding lips firmly while sucking
- For babies with cleft palate, it would be effective to use an artificial palate (such as Hotz-type Orthopedic Plate)
3) Sucking and swallowing for babies with micrognathia: Summary of symptoms
- A smaller jaw, receding mandible, or depression of the root of the tongue would block the respiratory path, causing sucking and swallowing disorders.
- Robin Sequence is characterized by a small or receding mandible, depression of the root of the tongue, cleft palate, and obstruction of airway. Airway obstruction or cleft palate could affect sucking ability of babies because of the difficulty in generating negative pressure within the oral cavity.
- Also the babies with Robin Sequencde usually have an U-shaped cleft palate. As a result, backward flow of breastmilk and formula enters the nasal cavity of the babies.
Ways of treatment:
- Because the babies with micrognathia have respiratory disorders frequently, it is essential to check if the airway is blocked while nursing.
- For more effective nursing, it could be recommendable to hold the baby on the vertical position, or pronely if needed, so that the airway could not be obstructed or the tongue of the baby could not recede.
- In the case that the baby with micrognathia would also have a cleft palate, it is necessary to take care of the cleft palate itself.
