Prematurity

Not all pregnancies go as planned and some babies are born early. A preterm baby is born before 37 weeks of pregnancy. Premature babies are more likely to have immature skills in areas including feeding and may require additional support.

The speech pathologist in NICU assists babies who have difficulties with suck feeding. Babies may be more at risk of suck feeding difficulties when they are born prematurely as they may have difficulty with breathing or feeding coordination. The speech pathologist works in conjunction with the NICU team and lactation consultants, to help babies with their suck feeding. This includes transitioning to breast and/or bottle feeds.

Cleft Lip and/or Palate

A cleft lip/palate is a structural anomaly where the normal lip and palatal structures do not close during development. A cleft can be unilateral (one side) or bilateral (both sides). Approximately 1 in 700 children are born with a cleft lip and palate in Australia. Sometimes there is a family history of cleft however most often cleft is sporadic with no history or known cause. A cleft lip may be able to be identified during antenatal scans. Babies with cleft palate tend to be diagnosed once they are born.

The speech pathologist in NICU assists babies who have been born with a cleft lip and/or palate. Babies are at risk of feeding difficulties when they are born with a cleft as they often have difficulty with sucking. The speech pathologist works in conjunction with the NICU team and lactation consultants, to help babies with their feeding. Depending on the type and location of the cleft, some babies will not be able to breast feed but can still have expressed breast milk from a bottle and cleft palate teat.

Babies with a cleft lip and/or palate are referred to the Cleft Palate Team, a multidisciplinary team comprised of professionals from medical, surgical, dental and allied health disciplines. The Cleft Palate Team provides longitudinal care across a child’s lifespan. To learn more about this service please click here.

Other

The speech pathologist in NICU assists babies who have difficulties with suck feeding and/or swallowing. Babies who may be at risk of sucking and swallowing difficulties include:

• Infants who are born very prematurely or have very low birth weight.
• Infants with hypoxic ischaemic encephalopathy
• Infants with known neurological history e.g. seizures, stroke, meningitis
• Infants with low muscle tone/increased tone impacting feeding
• Infants with cardiac anomalies
• Infants with a known or suspected genetic condition
• Infants with gastrointestinal disorders e.g. gastroschisis, tracheo-oesophageal fistula

These babies may have difficulties with breathing and feeding coordination which can impact on feeding success and growth. The speech pathologist works in conjunction with the NICU team and lactation consultants, to help babies with their suck feeding and ensure safe swallowing.

PICU provides an intensive care service to children and young people who are critically ill, recovering from major surgery or who have sustained major trauma. Having a child in intensive care can be very stressful. The unit is committed to providing safe, high quality care and works in partnership with the child’s family/carers.

The PICU is staffed by Paediatric Intensive care Doctors and Intensive care nurses. Doctors from across the Children’s Hospital along with a number of allied health staff contribute to the care of children and young people admitted to PICU. A speech pathologist may be a part of this team and will assess your child’s communication and swallowing. The speech pathologist will work in conjunction with your child’s team to ensure the best possible outcome for your child.

John Hunter Children’s Hospital has three paediatric wards. The three wards are:

• Ward J1 – Children’s Surgical and Oncology Ward
• Ward J2 – Adolescent Ward, Day Stay and Sleep Unit
• Ward H1 – Children’s Medical Ward

During your child’s stay in hospital, a speech pathologist may be asked to assess your child’s speech, language, voice and/or swallowing and determine whether there are any difficulties. These difficulties are then discussed with your family and your child’s medical team and a treatment plan is put into place. This may involve further instrumental or formal assessment, identification of therapy goals, treatment and review. Once your child is medically ready to leave the hospital, the speech pathology team will assist with the transition to community speech pathology services to ensure continuity of care.

Following a major injury, illness or medical procedures, your child’s medical team may work in partnership with the Paediatric Rehabilitation team. This team includes medical, nursing and allied health staff and focuses on enabling children to achieve their highest level of independence.  An individualised program will be designed to achieve specific goals in areas such as mobility, self-care and communication. Speech pathology may be involved in your child’s rehabilitation team depending on the goals of the treatment. The speech pathologist will assess, manage and treat your child’s communication and/or swallowing difficulties and will assist with the transition from hospital to community to ensure follow up is provided in a timely and effective way.

Paediatric Brain Injury Team (PBIRT)

The Paediatric Brain Injury Team (PBIRT) is a community-based rehabilitation team. It provides specialist multidisciplinary assessment and case management for children and young people with acquired brain injuries. It is staffed by a mix of medical, nursing and allied health staff and offers specialist support and education. A speech pathologist is involved in this team and will assist with rehabilitation clinics, care planning, goal focused rehabilitation programs, consultation on therapy regimes, liaison with education and school support staff, home/school program and referral to and ongoing liaisons with local speech pathology services.