How to stimulate infant eating
The following two exercise programs can help support your baby's eating. The exercises are intended for infants who have difficulty sucking and swallowing by themselves. Your occupational therapist will show you how to perform the exercises with your baby.
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The following two exercise programs can help support your baby's eating. The exercises are intended for infants who have difficulty sucking and swallowing by themselves. Your occupational therapist will show you how to perform the exercises with your baby.
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The purpose of body stimulation is to promote your baby’s sense of their own body and help them to develop their motor skills to eat.
Lay the baby on their back on a changing table or on a mat. Perform these exercises before those for sucking stimulation. The body stimulation should last about 5 minutes in total, each exercise should be performed 3-5 times. You may perform the exercises on both legs or arms at the same time, or you can perform each exercise individually
When the body stimulation is complete, the baby should be relaxed and at rest in both body and breathing and is ready for the next steps: sucking stimulation and eating.
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1. Legs
Grasp both of the baby's lower legs and squeeze with a firm and vibrating pressure up the legs from the feet to above the knees and back again.
2. Feet
A) Grasp the feet. Swipe and press with your thumb from the big toe to the little toe, to the heel and outside of the heel and then back again.
B) Place the baby's feet on the flat surface and apply an energetic pressure to the baby knees in the direction of the surface. This energetic push and release is called led-approximation.
C) The baby 's palms are relaxed against the surface. Now push the knee in the direction of the hip so that the joint approximation affects the knee and hip joints.
3. Stomach
Place your fingertips on the baby's stomach – at the navel – and swipe towards the hip and shoulder, respectively, and back again, crossing the upper body.
4. Pelvis
Hold the baby's pelvis with both hands and lift the pelvis off the ground. Your thumbs should be at the navel. Make side-to-side rotation movements so that the right and left hips are rotated down towards the ground.
5. Arms
Squeeze the baby 's upper arms with a firm pressure, starting at the shoulder then working down to the hands and back again.
6. Hands
Bring your baby’s hands together onto their stomach and then up towards their mouth allowing them to feel their mouth with their hands. Also repeat this exercise 3-5 times, moving your baby's hands back and forth.
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The purpose of the exercises is to "centre" the baby so that it becomes ready to use its strength to eat.
The exercise program takes around 2-3 minutes, and you should repeat each exercise 2-3 times. Use the program before every breast or bottle feed so that the baby expects the following feeding.
For the exercises below in which your baby feels your hands in their mouth, it is a good idea to use gloves. Both for the sake of hygiene and so the baby gets used to a therapist with gloves performing the exercises with the baby too.
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As a starting point, your baby should be calm in body and breathing before sucking stimulation and feeding. If necessary, start by performing Calma Motora.
Place yourself in the starting position
Your baby should lie with their head in a straight extension of their body. The hands should be gathered in front of their chest and the feet supported by, for example the end of a sofa or by a pillow that is fixed in place. The baby must be able to kick against the support. This calms your baby down and promotes their ability to swallow.
Place one hand on the back of the baby's head. It is important that you avoid touching the neck, as this can trigger a tonic reaction which causes the baby’s neck to automatically stiffen. Place the other hand on the baby's chest/sternum.
Perform calm movements
Lift the baby's back and head at a 45-degree angle. On the baby's exhalation, pull and vibrate with one hand on the back of the baby's head in the direction of the skull, upwards so that the head nods slightly. The vibration should be constant, rhythmic and calm.
At the same time, press and vibrate downwards with your other hand on the baby's sternum, in the direction of the back and feet.
On the baby's inhalation, you release the pull and pressure but continue to keep your hands on the back of the baby's head and on their chest. Repeat for 5-10 breaths.
It can be difficult to follow the breathing in smaller babies, which is often relatively fast. In which case, follow every other inhalation and exhalation.
Achieve motor calm
You will be able to notice when the tonic reactions in the body - the automatic stiffening of the muscles – disappear, by the baby's hands approaching your hand on their sternum. At the same time, the tension in their legs decreases, so they bend slightly.
The baby is now motorically calm, and you can continue the exercise program by stimulating the sucking reaction.
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When you need to stimulate the baby's sucking reaction, a special grip is required, which is described here:
The ring and little fingers are placed on the front part of the floor of the mouth, under the chin. The thumb and middle finger are placed on each cheek. The index finger is ready to be inserted into the mouth.
1) Press and vibrate with your thumb and middle finger on both cheeks in a motion towards the corners of the mouth.
2) Lightly vibrate upwards on the floor of the mouth with the little and ring fingers to ensure that the mouth closes.
3) Insert the index finger into the baby's mouth, press downwards and pull the finger outwards so that the finger is brought out of the mouth in a stretching motion.
4) Lightly swipe upwards and inwards with ring and little fingers under the base of the mouth.
5) Press the small elevation in the upper jaw – where the middle incisors should come – for 5-10 seconds with pressure and movement that mimics the sucking function in force and rhythm.
6) Then food is given.
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If you have any questions, please feel free to contact us. If you want to know more about the theory on which the exercises are based, you should search for Castillo-Morales' treatment concept and Bjørn Russell's stimulation method.
Neuropaediatric Team, Department of Paediatrics
Tel. 97 66 33 35 / 97 66 33
Best time to call: Monday – Friday 8.00 – 16.00
Department of Pysiotherapy and Occupational Therapy
Tel. 97 66 42 10