Brief presentation on Need of OT for premature infant

1. A VERY simple way to connect…
• BE FACE TO FACE!!! 

2. What is Occupational Therapy??
• Common belief that OTs help people return to
work following injury or illness.
• This is only part of the picture.
• “Occupation” actually refers to any activity that
you do during the day
• Self care activities
• Work and productive activities
• Leisure / Play activities

3. Infants learn and develop most of their
skills through play.
Skills OTs typically work on with infants
• Fine motor skills
• Visual perceptual and visual motor skills
• Play skills
• Sensory processing skills
• Gross motor skills
• Oro-motor skills

4. Occupational Therapy with
Premature Infants

5. Objectives
• Discuss the differences between full term
and preterm or very low birth weight
(VLBW) infants.
•Role of occupational therapy in KMC.
•Discuss role of occupational therapy in
assessment & treatment of pre-term
infants.

6. Immediately after birth, the learning
process begins with its dependence on
experiential opportunities, sensory
inputs and neurologic maturation

7. Preterm infants
•Floppy or flaccid muscle tone
•Decreased physiological stability
• Higher risk for feeding/swallowing
issues
•Delayed developmental milestones
•Smaller, less stable oral/pharyngeal
structures

8. State Control: Stress Cues
Furrowed brow/gaze
aversion
• Pursed or rounded lips
• Finger/toe splays
• Upper/lower extremity
extensions
• Frantic movements
• Arching
•Flaccidity
• “ Shutdown”

9. State Control:
Regulatory (readiness) cues
• Relaxed expression/body
posture
• Tucking
•Hands clasping
• Hands to mouth
• Drowsy to awake state
• Rooting/sucking

10. Nutritive sucking
•Considered the most complex activity of
infancy
•Can be a sensitive indicator of central
nervous system integrity
• Oral motor function is an important
indicator of neurobehavioral maturation
in pre-term infants
•Robust suck/swallow/breathe
synchrony ensures adequate nutritional
intake for growth

11. Prenatal Oral Motor/Swallowing Development
Development
Gestational Age Behavior
16--17 weeks Swallowing regulates
amniotic fluid
28 weeks Rooting, sucking and Rooting,
swallowing reflexes
32 weeks Gag reflex and non--
nutritive suck present
34 weeks Functional suck--swallow--breathe
pattern, but poor endurance
36 weeks Coordinated nutritive
suck

12. Difference between Non-Nutritive vs.
Nutritive Sucking
Non-Nutritive Sucking (NNS)
• 2/second
•6-8:1 suck/swallow ratio
• Maintains same number of
sucks per burst throughout
• Maintains same duration of
breathing breaks throughout
Nutritive Sucking
• 1/second
• 1:1 suck/swallow ratio
• Number of sucks per
burst decreases as feeding
progresses
• Duration of breathing
breaks lengthens as
feeding progresses

13. The Suck Swallow Disturbance in the
Premature Infant
• Inability to coordinate respiration and
nutritive swallowing
• Cessation of respiration (swallowing
apnea) occurs during nutritive and non-
nutritive swallowing in preterm infants
• Immaturity of neurological , anatomical,
and respiratory, systems influence
swallowing integrity

14. Non-Nutritive Sucking (NNS)
•Aids digestion
• Improved gastric motility and function
• Improved state control
•Promotes weight gain
•Earlier transition to oral feeding
•Earlier hospital discharge
Bernbaum et al, 1983; Widstrom et al,
1988; Ancona eBernbaum et al, 1998t 1998

16. Kangaroo Care
•Holding baby skin- to-skin
(against the parent parent’s chest) for
varying lengths of time.
• Premature and sick babies that
"kangaroo" appear to relax and
become content.
• This can also help parents feel
closer to their babies assisting in
the bonding process.
Numerous studies have shown that
Kangaroo Care has many health benefits
Including:
• Improved thermoregulation, heart rate, oxygen
saturation, and weight gain
• Significant increase in maternal milk volume
• Ideal prerequisite for early breastfeeding - mother can
observe infant feeding cues and rooting

17. Movement is important for children’s
development and learning

18. Areas that Occupational therapist work on
with infants
• Gross motor development milestones
(GMDM)
• Fine motor development
• Movement patterns
• Postures
• Oral motor stimulation
• Sensory processing skills

19. ASSESSMENTS USED BY O.Ts
• Modified version of GRIFFITH mental
development scale (locomotor, personal-
social,language,ocular co-ordination,
execution) to calculate mental and
chronological age
• INFANIB ( Infant Neurological International
Battery)
• Phataks
• Sensory profile

20. Significant GMDM (3wk-18m)
Lift head when on tummy……3m
Rolling………………………….4-6m
Sitting…………………………..6-8m
Crawling……………………….8-10m
Standing……………………….9-12m
Walking unsupported…………9-18m

21. 
Thank you