Feeding and Swallowing Assessment and Management for Infants With CHD
Presented by Hema Desai
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There is not a sufficient amount of information in the literature discussing assessment and management considerations for feeding and swallowing difficulties in the postoperative infant with congenital heart defects. This course will benefit clinicians working with this population by helping them understand the key components of a feeding and swallowing assessment during the acute postoperative stage. The treatment and management of feeding and swallowing difficulties must consider postoperative recovery and use of neuroprotective strategies to facilitate positive oral experiences and safe and efficient oral feeding development. The importance of a multidisciplinary approach to support the infant and caregiver will also be discussed.
Meet your instructor
Hema Desai
Hema Desai is an inpatient speech pathologist who has worked with infants and children with feeding and swallowing disorders since 2000. She has her board-certification specialties in swallowing and swallowing disorders (BCS-S) and neonatal touch and massage (NTMTC) and is a clinical lactation education counselor (CLEC). Hema…
Chapters & learning objectives
1. Postoperative Feeding and Swallowing Assessment for the Infant With CHD
Feeding and swallowing assessment of the postoperative infant with CHD must consider the consequences of surgery, side effects of medications, and possible respiratory challenges in addition to subsystem stability and neuromotor skills. Assessment must include neurobehavioral assessment to ensure appropriate readiness for oral feeding.
2. Post-Op Treatment Strategies: Prefeeding Skills and Neurodevelopmental Strategies
Early intervention to provide positive oral experiences via oral stimulation is vital to prefeeding skill development. As the infant becomes more medically stable, use of neurodevelopmental strategies to achieve and help the infant maintain state regulation and use of cue-based feeding can facilitate development of appropriate neural pathways for the acquisition of feeding and swallowing skills.
3. Post-Op Treatment Strategies: Environment and Positioning
External factors such as the stressful intensive care environment or poor infant positioning can be a barrier to successful oral feeding. Modifications to the environment and use of appropriate positioning strategies are helpful to achieve state regulation and respiratory stability for improved oral feeding.
4. Post-Op Treatment Strategies: Aspiration and Developmental Care Practices
Infants with CHD are at risk for swallowing difficulties resulting in aspiration and potential for respiratory complications. Strategies to address swallowing coordination and decreasing risk for aspiration will be discussed. The use of developmental care practices in the postoperative period is also important for oral feeding success and improving parent/infant bonding.
5. Postdischarge Management for Feeding/Swallowing Difficulties in Children With CHD
Multidisciplinary care is essential for the management of the infant with CHD after hospital discharge. Medical providers, rehab therapists, psychosocial therapists, and registered dietitians work together to support the infant’s growth and development as well as parent/caregiver mental health.