Mealtime Partners, Inc.

Specializing in Assistive Dining and Drinking Equipment

October 2014 Independent Eating and Drinking Newsletter

Independent Eating...   is a Wonderful Thing

October Topics:

  • How Infants Learn to Eat

  • As We Age

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How Infants Learn to Eat

How our dining behaviors have evolved in different areas of the world was discussed in last month’s newsletter. In this month’s newsletter we will examine how eating and drinking and the associated seating and positioning develops from infancy into childhood.

When human babies are first born they are dependent for all of their care to be able to survive. This is because their muscles have not developed enough to allow them to control their movements and facilitate being able to sit, stand or use their hands. However, in the first 12 months of an infant’s life they will develop and change more than any other time in their life. These developmental changes affect drinking and eating significantly during the early stages of an infant’s life.

A newborn infant has so little muscle tone that they are unable to hold their head upright whether they are being held vertically or horizontally. Typically, when a newborn infant is fed they are held in the arm of the person feeding them. They recline with their head supported by the bend of the arm at the elbow. If they are being breast fed, they will be held in both the right and left arms to enable them to nurse from both breasts. If they are being fed from a bottle, parents frequently hold the infant in their non-dominant arm and hold the bottle with their dominant hand. This allows them to better control how they present the nipple to the infant. As the infant matures they do not require such careful control of the nipple.

At birth the tongue of an infant pushes everything, other than a nipple, out of his or her mouth. This is known as a tongue thrust reflex which is a safety mechanism to protect the baby from swallowing items that they cannot handle. It will gradually fade as an infant matures and becomes ready to start eating foods rather than exclusively drinking liquid from a nipple.

In the first weeks of life an infant learns to suck and swallow in a coordinated manner. The typical infant will take one or two sucks and then stop sucking and swallow. Without this coordination, an infant will choke or even aspirate. (However, premature babies may not have developed this coordination at birth and may require tube feeding rather than oral feeding.) Most pediatric specialists in the United States recommend breast or bottle feeding exclusively until the baby is approximately 6 months old.

Within the first months of life, infants become able to hold their head up without it flopping, their eyes are able to focus on things around them and can track moving objects. They are able to grasp toys, Mom or Dad’s fingers, or their own toes and bring them to their mouth. They can roll from their stomach to their back and vice versa. By six months many infants are beginning to be able to sit up on their own. Their back muscles become strong enough for them to be able to sit without support. When a baby is first placed in a sitting position without support, they topple over. Gradually they learn to hold themselves upright by putting their hands and arms on the ground to provide stability. With repeated sitting, falling and putting their arms out, they strengthen their arm and back muscles and become able to sit independently. The next step will be for them to sit themselves up from a prone position.

By the time a baby is ready to start eating cereal or pureed fruit they are able to put their hands around a bottle and hold it, but they are not able to hold it consistently throughout a meal. Their oral development has matured enough to allow them to suck thin foods off of a baby spoon. Gradually, with experience, they will stop sucking the food into their mouth and start allowing the spoon to be placed into their mouth and they will use their upper lip to strip the food from the spoon. During this period the food that they are consuming will be sucked and swallowed in the same synchronized way that they drink. However, as different textures of food are introduced and self-feeding starts, oral organization of food will include moving the food around inside the mouth, gumming it, and forming it into a ball or bolus, in preparation for swallowing.

By the time the baby reaches their first birthday they should be using their fingers to pick up small pieces of food and putting them in their mouth. Also they should be learning to drink from a Sippy Cup and may even be beginning to drink through a straw. Their lip closure should have developed enough to hold pureed and soft solids in their mouth. Additionally, they should have cut some of their front teeth. With the development of teeth, eating and oral behavior evolves to include biting and chewing. By the time the toddler is 3 they will have a full set of “baby” teeth. Between the age of 1 and 3 a toddler will learn to hold a utensil and feed themselves.

In summary, this article briefly has described how infants develop their ability to eat and drink until they are able to perform both functions in a relatively mature manner. Despite there being much more for them to learn, the basic skills should have been developed by the time they are 3 years old. They should be able to: sit in an upright position to eat; hold and use utensils and/or a cup; chew and swallow most solid foods; and, be able to drink from an open topped cup. Regardless of where they are born, by three year olds they should sit independently to eat and feed themselves in the manner that is appropriate for their culture.

Parents should always be aware of how their baby is progressing, bearing in mind that babies develop at different paces, and there is no absolute as to when they should do certain things. The Centers for Disease Control and Prevention (CDC) offers an overview of infant development schedules and milestones at: http://www.cdc.gov/ncbddd/actearly/milestones/index.html. If anyone has concerns about their infant’s development they should discuss them with a medical professional.

For infants identified as having developmental disabilities, intervention in the form of therapy should be initiated as early as possible. The goal should be to assist infants to develop on a schedule that is comparable with their peers. For those infants for whom therapy cannot mitigate the problems created by their disability, assistive technologies should be considered. For those little children who are unable to self feed the Mealtime Partner Dining System is beneficial as not only a way of being able to eat independently but also as a teaching tool. Because it can be operated using adaptive switches, it allows small children to understand cause and effect, to become competent switch users, and to comprehend that they are able to do things for themselves. The Mealtime Partner Dining System can be used by children as young as 3 years old.

Click here for more information about the Mealtime Partner Dining System.

 

The Mealtime Partner Dining System empowers those who use it to greater independence and greater control over their lives.
At mealtimes:  
  • They are able to pace when they will take each bite of food. They can eat as quickly or as slowly as they wish, taking each spoonful of food into their mouth when they choose.
  • They can decide what they will eat, or won’t eat, from the foods that are served. They are even able to change their minds, once a spoonful of food is served, should they decide not to eat it, and can return it to the bowl from which it came.
  • They are able to pause, if they want, to listen to and/or participate in mealtime conversation.
Child Using a Mealtime Partner Dining Device
The very versatile Mealtime Partner Dining System can accommodate the diverse needs of individuals who have spinal cord injuries (SCI), Parkinson’s disease, arthrogryposis, cerebral palsy (CP), amyotrophic lateral sclerosis (ALS), and many others.

The Mealtime Partner Dining System can be positioned to meet the specific needs of each user. The user does not have to adjust their position to eat using the device because the Partner’s flexible mounting systems permit positioning to fit the user's needs, making mealtimes a comfortable, relaxed experience, with the user positioned safely for eating.

The Mealtime Partner empowers its user to eat what they want, when they want it.

The Mealtime Partner Dining System is quick and easy to learn and has no complicated programming requirements. Each Dining System comes with a complete training video on DVD so new users and caregivers can learn to use it in just a few minutes. Click here to view some of the instructional videos.

For more information about the Mealtime Partner Dining System, please visit
Mealtime Partners website. There is no other assistive dining system that meets the needs of the users, like the Mealtime Partner.

As We Age

The first article in this month’s Newsletter discussed the beginning of life and how infants develop the ability to eat and drink independently. This article will address some of the problems relating to aging and how aging impacts the ability to eat, drink and position ourselves to undertake these activities.

As we age we develop illnesses, acquire injuries and catch diseases that affect our well being. These can limit our ability to move around independently, and take care of ourselves. They can inhibit our ability to eat independently, hold a cup to take a drink and swallow safely. These are not limits that are directly associated with the aging process but they occur more commonly in older people as is discussed below.

It is estimated that approximately 52.5 million adults in the United States have some type of arthritis. In older people, arthritis can restrict their ability to move around freely because arthritis can affect their hips, knees and/or back. Thus getting to the table and sitting at the table can be difficult. Also, arthritis commonly affects the hands and wrists which limit the ability to hold utensils, cut up food, and feed ones self. As a result of these limits, many elderly individuals do not eat enough and gradually loose a significant amount of weight and, in general, experience a decline in health, quality of life, and feeling of well being. Also, many of them suffer from some level of dehydration which can seriously affect their overall health.

Stroke accounts for 1 in 19 deaths in the U.S. Every year almost 795,000 Americans have a stroke, many of whom are elderly. There are two types of strokes. An ischemic stroke occurs when the flow of oxygenated blood is cut off from the brain due to a blockage in an artery, or vein. Within minutes of the brain being deprived of oxygen, brain cells start to die. A hemorrhagic stroke occurs when an artery in the brain leaks or ruptures. Frequently this type of stroke is fatal. When brain cells die during a stroke, abilities controlled by that area of the brain are lost. These abilities often include speech, movement, and memory. How a stroke impacts the individual depends on where the stroke occurs in the brain, and how much the brain is damaged. Often strokes cause very serious long-term disabilities. Many people who survive a stroke have difficulties with speech, eating, and drinking and special care is necessary to facilitate their nutritional and hydration needs being met. Mealtime Partners provides specialty cups to assist with hydration for stroke patients (i.e., the Provale Cup, the RiJi Cup, and the Thickened Liquids Cup), but guidance from a physician or speech language pathologist should be sought when selecting equipment and developing strategies for eating and drinking for a stroke patient.

According to the Centers for Disease Control (CDC), falls are the leading cause of fatal and non-fatal injury for Americans 65 years, and older. Each year, about 35% to 40% of adults 65 and older, fall at least once. After falling, many older people are worried about falling again and begin to limit their movements and move more slowly. This has a spiraling effect. The reduction in movement weakens muscles and joints, and deprives the body of cardiovascular exercise. Thus the individual is less healthy; they burn less energy due to lack of movement and are less hungry. If someone has fallen, the cause of their falling should be examined and treatment sought. Many elderly people limit where they go and how often they leave their home due to a fear of falling. There are programs in place in many communities that teach those who have fallen how to improve their balance and avoid falling. The National Council on Aging offers recommendations about programs to enhance balance at http://www.ncoa.org/improve-health/center-for-healthy-aging/falls-prevention/community-programs.html.

In 2009, there were 33 million licensed drivers ages 65 and older in the United States. Driving helps older adults stay mobile and independent. But the risk of being injured or killed in a motor vehicle crash increases as you age. An average of 500 older adults is injured every day in crashes. Many hospitals now offer special driver training for older individuals which can evaluate weaknesses in driving skills and provide the necessary training to gain competence. Retaining the ability to drive safely provides many benefits to older people which relate to their nutritional intake. First, they are able to go shopping and can select the foods that they like. Secondly, they can eat out which has a dual advantage. Not only do they consume a meal that they didn’t have to prepare, they are able to eat with friends, and thus, have increased social exposure. Also, both of these activities encourage walking which is good exercise.

Many people experience cognitive impairments as they age. In most cases the initial sign of a problem is memory loss. Everyone experiences some memory loss with age but, in some cases, the memory loss is a prelude to mild cognitive impairment (MCI), dementia, and Alzheimer’s disease. Dementia is caused by neurons (nerve cells in the brain) dying, or malfunctioning. When this type of brain damage occurs, memory changes usually occur and the ability to think becomes impaired. Alzheimer’s disease is a sub-set of dementia. It gradually robs those impacted by it of the ability to execute activities of daily living such as: eating, dressing, and bathing. Gradually, they loose the ability to walk, talk and even swallow. It should be noted that not everyone who suffers from memory loss is destined for dementia. In many cases there are causes that are treatable. One of the most common treatable causes is medication. Some medicines can have side effects that impact memory; other drugs interact with each other, and cause problems. Before jumping to the conclusion that memory loss is caused by the onset of dementia, check with your physician to evaluate other reasons for memory loss.

For those who are impacted by illness and disease, nutritional and fluid intake is important. Mealtime Partners provides a range of products to allow individuals who are unable to feed themselves or take a drink without help, to continue to be able to conduct these activities independently. For more information about all of the Mealtime Partners Eating and Drinking Systems, please visit the Mealtime Partner website.

Did You Know? Did you know some people have difficulty drinking through a straw because they cannot make their lips seal around the straw, and so they cannot create a vacuum? This commonly occurs when someone has poor lip control. It can be temporary or a permanent limit. To understand what it feels like to have this problem, remember the last time you went to the dentist and had your mouth numbed. After your dental treatment, when your lips were still a little bit numb, you could not control them fully. If you tried to take a drink you may have dribbled. Sometimes applying lip balm before taking a drink can help to create a seal around the straw. Flavored lip balm is helpful because the flavor provides extra awareness of the lips. For some people, peanut butter works even better because it has a thick texture and bonds well between the lips and straw. Be creative – try sticky foods that the person likes. You might find something that is enjoyable as well as helpful.






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