Baby Intubation and Development - Breathing and Cranial Suture Midlines.
Jan 19, 2024
As you know, I work with a lot of children that have had time in the NICU. Not all NICU stays are dealing with respiratory distress however, they do usually involve facial pinning. I would like to start discussions of milestone availability and facial/cranial interruptions of development.
Many of you know, that I can 'see' or notice the movement presence of devices that impede movement during the application. A baby's body can remain in the situation - long after the device has been removed.
I do want to stress that medical intervention is necessary and shouldn't be avoided or have a sense of guilt around the course of actions taken to save your child's life. I would like to make this information more available so that you can take the steps needed to bring back movement into your child's life.
Let's look at intubation.
Your child breathing is now being forced through an endotracheal tube (ET). This tubing goes through the mouth and into the airway. I've clipped several random pictures below and you can see the way the equipment goes across the entire mandible/maxillary.
In some cases, the taping is wrapped around the nose and tape is used to secure tubing. Most infants are placed on their backs. When they are on their side, you can see the positioning of the nose protruding above the jaw bone.
POSSIBLE MOVEMENT COMPLICATIONS:
Most children, that have been intubated, usually have very little upper lip movement, similar to tethering of the upper lips.
Their tongues are unable to come out past the lips or move in any kind of circular movements. Speech may be diagnosed as apraxia.
Vocal cords/swallow may not have the strength to coordinate.
Use of straws can be difficult. It can me hard to smile due to tape on the cheeks. Difficulties with convergence and binocular vision with a higher chance of strabismus. Low ability for peripheral vision.
Another visual reference: Notice that the baby's arms typically are set in a folded position with and IV.
There is a higher chance that a child will be unable to move around without the arms folded. Proprioceptive and vestibular issues might show up.
EFFECTED SUTURES: Intermandible, intermaxillary, Internasal, Zygomaticomaxillary
SECONDARY SUTURES: Frontozygomatic, Temporozygomatic. Frontonasal, Coronal