Pediatric Dysphagia 

Patient will safely ingest diet trials during therapeutic feedings with the SLP without signs and/or symptoms of aspiration with to safely consume least restrictive diet with min verbal, visual, and tactile cues as observed by SLP data.

"Coregulated Approach to Feeding Preterm Infants With Lung Disease" demonstrates that using the infant's cues as a guide when feeding infants born at less than 32 weeks gestation resulted in less variability in oxygen saturation, more stable saturations, less heart rate fluctuation and decline, improved swallowing and less excessive breathing effort (Shaker, 2013).

Pacing: A compensatory technique that can be used across all feeding situations and age ranges, (e.g. breast, bottle, cup, liquids and solids feeding).

For infants, pacing aims to increase safe oral intake by assisting the infant in coordinating their suck-swallow-breathe (SSB) cycle. Pacing also allows for the re-establishment of normal respiration that supports coordinated SSB patterns.

Cue-based feeding: Oral feeding based on Infant readiness. This Is also known as Infant-driven or Infant-led feeding. 

Responsive feeding: Focuses on caregiver and child dynamic. Responsive feeders attempt to understand and read a child’s cues for both hunger and satiety and respect those communication signals in infants, toddlers, and older children.

• How we feed our babies in infancy translates to how well/poor they will feed in the future.

• Stay current with research and steer away from quantity-driven feeding practices.

• Honor infants’ stress cues, allow the infant to speak to you during feeding with their cues.

• Providing appropriate compensatory strategies and know when to fade compensatory strategies.

• Knowing the benefit of a slower flow rate nipple, and the appropriate signs/maturity of when to transition to faster flow nipple (assistance from feeding therapist/SLP when needed).

The rate and frequency of pacing will depend on suck to swallow ratio, suck strength, age of the infant and feeding method. SLPs should consider equipment (e.g., type of bottle chosen and nipple flow rates).