What factors influence feeding and swallowing in children?
Answer
We typically see infants and children for feeding therapy or swallowing therapy because there's a disorder or a disruption in some aspect of feeding and or swallowing. The question we have to ask is “why?” What's the antecedent to that disorder or disruption? What are some of the factors that influence feeding and swallowing?
Medical and genetic diagnoses impact feeding and swallowing. There are so many children who are born premature and when that happens, they are much more susceptible to respiratory complications, congenital heart issues, necrotizing enterocolitis, et cetera. Those medical diagnoses are going to impact that infant on so many levels. Potentially, it makes them unsafe for swallowing but a medical diagnosis of prematurity can result in respiratory compromise.
It can also impact the child’s physiological status or motor status. It's definitely going to impact the child from a satiation-hunger standpoint. It's also going to impact the child in terms of the relationship with their parent, because the parent may not get to feed them as they normally would.
Developmental delays can influence feeding and swallowing, as can sensory impairments. If a child can't stand the way that something wet feels on their hands, it's unlikely that they are going to be able to interact with it with their mouth, tongue, or lips.
Social-emotional issues can influence feeding and swallowing. Certainly, some atypical social-emotional relationships can influence feeding and swallowing. Structural anomalies can definitely impact feeding and swallowing, particularly when they're not recognized and someone is trying to encourage you to eat and drink, and you're really not comfortable with that.
There is a multitude of other factors that also influence feeding and swallowing. Feeding is so complex, and swallowing is so complex, that any of these factors alone can negatively impact feeding and swallowing. However, it's important to consider that these factors can coexist.
Rhonda Mattingly EdD, CCC-SLP is an associate professor in the Department of Otolaryngology, H/N Surgery, and Communicative Disorders at the University of Louisville. She teaches courses in early language evaluation and intervention, pediatric feeding and swallowing, cognitive-communicative disorders, professional issues, and topics in audiology. Dr. Mattingly has been practicing for over 32 years and currently provides clinical services to neonates, adolescents, and adults with a variety of disorders including aphasia, cognitive impairment, voice dysfunction, slow feeding of the newborn, and dysphagia within the University of Louisville Healthcare System. She is active in research, publishes in scholarly journals, maintains membership in several professional organizations, and provides interdisciplinary continuing education to professionals across the globe.
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