PowerPoint Presentation

SUCKING

DEFINITION Rhythmic movements of an infants mouth & tongue either on the bottle or breast to obtain nourishment or on a pacifier, hand, or other object to modulate state or explore the environment.

In utero: 15 to 18 weeks of gestation*In extra uterine environment: 27 to 28 weeks, disorganized , weak, immature, random pattern32 weeks: stronger sucking, emerging burst-pause pattern34-35 weeks: stable rhythm***Iannirubero,A.,& E.Tajani.1981Ultrasonographic study of fetal movements. Seminars in Perinatology 5:175-181**Hack,M. et.al., 1985,Development of sucking rhythms in preterm infants. Early infant development 11:133-40SEQUENCE OF SUCKINGCentral groove of the tongue receives the nippleLateral portions of the tongue in contact with palateLips & tongue close around the nipplePosterior tongue elevates to maintain contact with soft palateCheeks approximate tongue & nippleMedial portion of tongue produces wave like motion antero-posteriorlyPosterior portion of tongue is depressedEnlarged oral cavity, negative pressure, suctionPropel bolus to pharynxMandible moves with the tongue in an ant.-inf.& post.-sup. direction BIOMECHANICS OF SUCKINGSucking PressureMouth acts a pumpPositive pressure: tongue compresses the nippleNegative pressure: closed oral cavity or suction pulls fluid into the mouth

BIOMECHANICS CONTD.Motor Components Tongue Anteriorly seals against the nipple, compresses the nipplePosteriorly seals against the soft palate until the palate is lifted for swallowing, creates negative intra-oral pressureCreates central groove in the antero-posterior direction, stabilizes the nipple & channels the bolus toward the pharynx BIOMECHANICS CONTD. JawStable base for movements of tongue, lips, and cheeksCreates intra-oral negative pressure with downward movement

Lips

Seals the nipple with the tongueStabilize nipple position

BIOMECHANICS CONTD.Cheeks

Fat pads provide stabilityProvides lateral boundaries for food on the tongue, thus aiding in bolus formation

Palate

Hard palate works with the tongue to compress the nipple & maintain nipple positionSoft palate with the tongue creates the posterior seal for the oral cavityElevates during swallowing to allow passage of the bolus, seal the nasal cavity & prevent nasal reflux

WHY DOESNT BABY WANT TO SUCKLE?

Sometimes a newborn baby doesnt suckle well and mom can feel desperate and helpless. There are many reasons for suckling problems. Some of them are:

a negative association to touch (can be due to needles, pain, etc.), resulting in the baby pulling away in order to self-protect a negative association to the smell of the surroundings, or if moms body is bathed in antiseptic or perfume bright lights a premature birth a difficult birth neuro-developmental delays problems with breathing or a lack of oxygen assisted birth moms anxiety early separation from mom at birth baby signaling time-out cues Thank You