Feeding and Swallowing Issues in Children With Neuro-Developmental Disorders

Introduction To Feeding And Swallowing

Feeding, in general, is a basic skill which exists from the beginning of infancy. It provides nutrition for normal growth and development; satisfies hunger and maintains the homeostasis, gives opportunities for sensory and motor stimulation, and oro-motor skill development, etc., thus serving to fulfill the biological functions of the body. Feeding also has a deep impact on the psychological aspect of a developing child. The behaviors of both parent/caregiver and child during feeding contribute significantly to the overall success of the feeding interaction as well as feeding performance, which in turn strengthen the mother-child bonding. Mealtimes with the family as well as outside the family play an important role in the social life of the child (Morris & Klein, 1987; Kummer, 2008).

The development of feeding in infancy depends on the maturation of gut, lungs and neural system. The functional and anatomic development of gut includes improvement in esophageal and intestinal motility, the functioning of the lower esophageal sphincter (LES), the process of ejection of stomach contents and development of the absorptive surface area of the gut. The respiration becomes more efficient by 32 to 34 weeks of gestation and continues to develop until two years of age. Our central nervous system matures in a peripheral to central sequence and our brainstem begins to mature by the second trimester. The brainstem controls our vital functions such as heart rate, blood pressure, digestion and sleep; and cerebral cortex regulates our functional life such as voluntary actions, thought process, memory etc. During early infancy, brainstem plays a major role in controlling all our life-sustaining reflexes (including breathing, suckling etc.) (Kliegman & Stanton, 2011; Kenner & McGrath, 2010; Gardner & Merenstein, 2002; Stiles & Jernigan, 2010).