Cute Baby Sneeze Sms Tone Download
Wisam Ammouri
Each subsystem can be described independently, yet functions in relation to the other subsystems. The autonomic system has to be functioning (the baby breathing and has a heat rate) to be able to assess an infant's ability to look at something. The process of subsystem interaction (how the five subsystems work together or influence each other) is what is meant by the term "synaction." This synaction is combined with the infant's continuous interaction with the environment to formulate the "Synactive Theory of Infant Development."
The basic concept underlying this approach is that the infant will defend him/herself against stimulation if it is inappropriately timed or is inappropriate in complexity or intensity. If an inappropriate stimuli persists the infant will no longer be able to maintain a stable balance of subsystems (e.g., decrease or increase in heart or respirations may be observed or skin color may change, or muscle tone decrease). If properly timed and appropriate in complexity and intensity, stimulation will cause the infant to search and move toward the stimuli, while maintaining him/herself in a stable balance (e.g., appropriate color, even heart and respiratory rate and/or good muscle tone).
In healthy full term infants these systems generally work smoothly supporting and promoting each other. In the preterm infant these systems are not fully developed and ready to function. Therefore, the preterm infant's behaviors are generally characterized by disorganization and signs of stress. The preterm infant is more dependent, than the full term infant, on its environment to help support and maintain balanced equilibrium.
Technology, which focuses care solely on the autonomic system (respiratory, cardiac, digestive and temperature control functions), comes at the expense of the motor, state, organizational and self-regulatory systems, which are intimately dependent on an adaptive environment. Signs of stress, by subsystem, seen in preterm or full term infants cared for in the NICU include:
What are some signs of stress? A lot of people know that finger splaying, or full extension of the hand is a stress sign. It is commonly called the stop sign in the NICU. You can see a taut mouth, nasal flaring, a furrowed brow, and then the stiffening or flopping of musculature. You can see this with neurological shutdown. When a baby is being asked to continue to eat when they have already given their stress cues over and over, they will eventually lose all their tone and do this flopping posture. Many parents will perceive that as, "They are just tired. Let's wake them up." The final result is a baby that either gets floppy or the opposite which is stiffening. Stiffening can be quite alarming especially for any babies who have had any type of adverse brain event. Basically, almost every baby in the NICU has had this either from early or traumatic birth. Stiffening is a full-body kind of rejection of what is happening at the moment. You are going to see that first, and then it will be followed by the flopping out or neurological shutdown. Those are the final stress cues that are going to shut a baby down. An eating experience at this point will not be beneficial to them.
This is a still picture, but it is very clearly a baby in a neurological shutdown. The baby has a leaky mouth and mottled skin color with blues and red. There are also two open palms. Fisted hands are a sign that tells us whether a baby is hungry and truly ready to practice eating. This is because they are alert and ready to go. They have the muscle tone that is ready to practice. A baby that is loose and limp is not.
For the motor system, we see decreased tone and a slack jaw. There is an excess leak around the mouth and unfisted hands. The baby is floppy in their musculature. They may have gone from a normal tone to low tone. Or, they maybe did a stiffening right before this and then flopped out into shutdown.
I did not want to talk over the video because I wanted you to start to use your own assessment of what you were seeing. A video like this probably would have been sent to dad. "Look how cute she is. We tried eating today." The alert state of this baby is almost nonexistent, and it does not take any training to recognize this is not the optimal time for somebody to practice learning to feed. We would not walk into an adult patient room, see them with their eyes cracked like this, and say, all right, "Time to get up and shower." Again, it does not matter whether babies are awake or asleep, or drowsy or crying. We are just focused on the agenda of getting this child fed versus watching the baby's cues.
This technique is commonly used in a NICU setting along with the cheeks. You squeeze the cheeks and pull the chin. It is like a double whammy for incorrect feeding. I am going to force the suction of the nipple, and then I am going to pull the chin out so that literally the baby is doing nothing on their own. This is used when a baby is poor tongue stripping and has a small chin or wide jaw. They kind of chomp on the nipple. The symptoms are a smacking noise, increased air intake, inefficient eating, and sucking a lot or not getting much. Infants with small chins and posterior tongues benefit from this slight forward pressure to pull chin forward. Likewise, infants with wide jaw excursions do as well. Babies with genetic issues and low tone may require chin support for the initial latch and then you can let go. Caution, do not push up or use chin support if it is not needed as this could make the infant orally aversive.